Drug interactions
Alprazolam + Fosamprenavir
Severity: Major
Alprazolam and Fosamprenavir: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fosamprenavir, via amprenavir, inhibits CYP3A4 and can increase alprazolam levels, leading to prolonged sedation and respiratory depression. Boosted protease inhibitor regimens increase this effect.
What this interaction means in plain words
Alprazolam and Fosamprenavir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Amprenavir, the active metabolite, inhibits CYP3A4, reducing alprazolam clearance.
What to do
Use a reduced alprazolam dose or choose a benzodiazepine less dependent on CYP3A4, such as lorazepam. Monitor for oversedation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Fosamprenavir?
MediHelp rates the interaction as major. Alprazolam and Fosamprenavir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fosamprenavir, via amprenavir, inhibits CYP3A4 and can increase alprazolam levels, leading to prolonged sedation and respiratory depression. Boosted protease inhibitor regimens increase this effect.
How serious is the interaction between Alprazolam and Fosamprenavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a reduced alprazolam dose or choose a benzodiazepine less dependent on CYP3A4, such as lorazepam. Monitor for oversedation.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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