Drug interactions
Alprazolam + Istradefylline
Severity: Moderate
Alprazolam and Istradefylline: 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
At higher doses istradefylline raises exposure to CYP3A4 substrates, which may increase alprazolam levels and sedation. The effect was not seen at the lower dose.
What this interaction means in plain words
Alprazolam and Istradefylline 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; Istradefylline belongs to Central Nervous System.
Why it happens
Istradefylline weakly inhibits CYP3A4 at higher doses, reducing alprazolam metabolism.
What to do
Monitor for increased sedation, especially at istradefylline 40 mg/day, and reduce the alprazolam dose if needed.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to see why Alprazolam and Istradefylline interact, what to do about it, and the sources.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Istradefylline?
MediHelp rates the interaction as moderate. Alprazolam and Istradefylline 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. At higher doses istradefylline raises exposure to CYP3A4 substrates, which may increase alprazolam levels and sedation. The effect was not seen at the lower dose.
How serious is the interaction between Alprazolam and Istradefylline?
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 increased sedation, especially at istradefylline 40 mg/day, and reduce the alprazolam dose if needed.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
