Drug interactions
Alprazolam + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Major
Alprazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir: 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
The ritonavir-boosted regimen strongly inhibits CYP3A4 and can increase alprazolam concentrations. This may lead to prolonged sedation, impaired psychomotor function and respiratory depression.
What this interaction means in plain words
Alprazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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
Ritonavir and paritaprevir inhibit CYP3A4 metabolism of alprazolam, reducing clearance.
What to do
Consider lowering the alprazolam dose and monitor for excessive sedation during therapy. Adjust the dose according to clinical response and reassess after the antiviral regimen is finished.
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 Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as major. Alprazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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. The ritonavir-boosted regimen strongly inhibits CYP3A4 and can increase alprazolam concentrations. This may lead to prolonged sedation, impaired psychomotor function and respiratory depression.
How serious is the interaction between Alprazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider lowering the alprazolam dose and monitor for excessive sedation during therapy. Adjust the dose according to clinical response and reassess after the antiviral regimen is finished.
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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