Comparative Pharmacology
Head-to-head clinical analysis: ALPRAZOLAM versus VALIUM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALPRAZOLAM versus VALIUM.
ALPRAZOLAM vs VALIUM
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.
Benzodiazepine that enhances the effect of GABA at GABA-A receptors, increasing chloride ion conductance and producing neuronal hyperpolarization.
0.25-0.5 mg orally 3 times daily; maximum 4 mg/day in divided doses.
Oral: 2-10 mg 2-4 times daily. IV/IM: 5-10 mg, repeat in 3-4 hours if needed; max 30 mg in 8 hours.
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 of diazepam: 20–50 hours; active metabolite desmethyldiazepam half-life: 36–200 hours (accumulates with chronic dosing, prolonging clinical effects).
Renal (approximately 80% as metabolites, <20% unchanged); fecal (minor, ~7%)
Renal: <1% unchanged; hepatic metabolism to active metabolites (desmethyldiazepam, temazepam, oxazepam); metabolites excreted renally as glucuronides. Fecal: minor.
Category D/X
Category C
Benzodiazepine
Benzodiazepine
"The serum concentration of Erythromycin can be increased when it is combined with Alprazolam."