Drug interactions
Alprazolam + Isoniazid
Severity: Moderate
Alprazolam and Isoniazid: moderate 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
Isoniazid inhibits CYP3A4 to a modest degree, which may raise alprazolam concentrations and increase sedation and psychomotor impairment. The effect is usually small but may matter in older or frail patients.
What this interaction means in plain words
Alprazolam and Isoniazid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Alprazolam belongs to Central Nervous System; Isoniazid belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4-mediated alprazolam metabolism by isoniazid.
What to do
Monitor for excess sedation and consider reducing the alprazolam dose in elderly patients. Counsel about driving and alcohol.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Isoniazid?
MediHelp rates the interaction as moderate. Alprazolam and Isoniazid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Isoniazid inhibits CYP3A4 to a modest degree, which may raise alprazolam concentrations and increase sedation and psychomotor impairment. The effect is usually small but may matter in older or frail patients.
How serious is the interaction between Alprazolam and Isoniazid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for excess sedation and consider reducing the alprazolam dose in elderly patients. Counsel about driving and alcohol.
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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