Drug interactions
Alprazolam + Posaconazole
Severity: Major
Alprazolam and Posaconazole: 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
Posaconazole markedly increases alprazolam exposure. This can cause excessive sedation, psychomotor impairment and respiratory depression.
What this interaction means in plain words
Alprazolam and Posaconazole 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.
Alprazolam belongs to Central Nervous System; Posaconazole belongs to Anti Fungals.
Why it happens
Posaconazole inhibits CYP3A4 metabolism of alprazolam.
What to do
Reduce the alprazolam dose and monitor sedation, or switch to a benzodiazepine not metabolized by CYP3A4 such as lorazepam.
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 Posaconazole?
MediHelp rates the interaction as major. Alprazolam and Posaconazole 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. Posaconazole markedly increases alprazolam exposure. This can cause excessive sedation, psychomotor impairment and respiratory depression.
How serious is the interaction between Alprazolam and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the alprazolam dose and monitor sedation, or switch to a benzodiazepine not metabolized by CYP3A4 such as lorazepam.
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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