Comparative Pharmacology
Head-to-head clinical analysis: ALPRAZOLAM versus PAXIPAM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALPRAZOLAM versus PAXIPAM.
ALPRAZOLAM vs PAXIPAM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Positive allosteric modulator of GABA-A receptors; enhances GABA inhibitory neurotransmission by binding to benzodiazepine site on GABA-A receptor, increasing chloride ion conductance.
PAXIPAM (flurazepam) is a benzodiazepine that enhances GABA-A receptor activity by binding to the benzodiazepine site, increasing chloride ion conductance and producing CNS depression.
0.25-0.5 mg orally 3 times daily; maximum 4 mg/day in divided doses.
5-10 mg orally every 8-12 hours as needed; maximum 40 mg/day.
None Documented
None Documented
12-15 hours (mean ~13 hours); prolonged in elderly (up to 19 hours) and hepatic impairment (up to 20-30 hours); clinical context: allows once- to twice-daily dosing, but risk of accumulation with high doses or in vulnerable populations
Clinical Note
moderateAlprazolam + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Alprazolam is combined with Fluticasone propionate."
Clinical Note
moderateAlprazolam + Haloperidol
"The risk or severity of adverse effects can be increased when Alprazolam is combined with Haloperidol."
Clinical Note
moderateAlprazolam + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Alprazolam."
Clinical Note
moderateAlprazolam + Erythromycin
Terminal elimination half-life is 30-40 hours in healthy adults; prolonged in elderly and hepatic impairment.
Renal (approximately 80% as metabolites, <20% unchanged); fecal (minor, ~7%)
Renal excretion of unchanged drug and glucuronide metabolites accounts for 60-70%; fecal excretion accounts for 20-30%.
Category D/X
Category C
Benzodiazepine
Benzodiazepine
"The serum concentration of Erythromycin can be increased when it is combined with Alprazolam."