General Toxicity Notes
May cause excessive sedation and encephalopathy in ESRD.
Excreted Unchanged %
Hepatic
Half-Life (Normalesrd) Hours
9.5-19.0/Unchanged
Plasma Protein Binding %
70-80
Volume Of Distribution L/Kg
0.9-1.3
Dose For Normal Renal Function
0.25-5.0 mg q8h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [D]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [D]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [D]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None, [D]
Supplement For Dialysis [Recommendation Level]: Pd
PD: No data, [D]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [D]
References
DeVane CL, Ware MR, Lydiard RB. Pharmacokinetics, pharmacodynamics, and treatment issues of benzodiazepines: alprazolam, adinazolam, and clonazepam. Psychopharmacol Bull. 1991; 27: 463-73. [PMID: 1687613] / Greenblatt DJ. Benzodiazepine hypnotics: sorting the pharmacokinetic facts. J Clin Psychiatry. 1991; 52 Suppl: 4-10. [PMID: 1680125] / Greenblatt DJ. Pharmacokinetics and pharmacodynamics. Hosp Pract (Off Ed). 1990; 25 Suppl 2: 9-15; discussion 16-8. [PMID: 2114417] / Greenblatt DJ, Harmatz JS, Dorsey C, Shader RI. Comparative single-dose kinetics and dynamics of lorazepam, alprazolam, prazepam, and placebo. Clin Pharmacol Ther. 1988; 44: 326-34. [PMID: 3138056] / Laurijssens BE, Greenblatt DJ. Pharmacokinetic-pharmacodynamic relationships for benzodiazepines. Clin Pharmacokinet. 1996; 30: 52-76. [PMID: 8846627] / Norman TR, Burrows GD, McIntyre IM. Pharmacokinetic and pharmacodynamic effects of a single nocturnal dose of alprazolam. Int Clin Psychopharmacol. 1990; 5: 111-7. [PMID: 2199575] / Ochs HR, Greenblatt DJ, Labedzki L, Smith RB. Alprazolam kinetics in patients with renal insufficiency. J Clin Psychopharmacol. 1986; 6: 292-4. [PMID: 3771810] / Scavone JM, Greenblatt DJ, Shader RI. Alprazolam kinetics following sublingual and oral administration. J Clin Psychopharmacol. 1987; 7: 332-4. [PMID: 3680603] / Schmith VD, Piraino B, Smith RB, Kroboth PD. Alprazolam in end-stage renal disease: I. Pharmacokinetics. J Clin Pharmacol. 1991; 31: 571-9. [PMID: 1880224] / Smith RB, Kroboth PD. Influence of dosing regimen on alprazolam and metabolite serum concentrations and tolerance to sedative and psychomotor effects. Psychopharmacology (Berl). 1987; 93: 105-12. [PMID: 3114808] / Smith RB, Kroboth PD, Vanderlugt JT, Phillips JP, Juhl RP. Pharmacokinetics and pharmacodynamics of alprazolam after oral and IV administration. Psychopharmacology (Berl). 1984; 84: 452-6. [PMID: 6152055] / Talmud J, Straughan JL, Robins AH. Alprazolam— a new triazolobenzodiazepine. S Afr Med J. 1984; 66: 297-8. [PMID: 6147900]