Alprazolam Contraindications

Use of alprazolam should be avoided, or carefully monitored by medical professionals, in individuals with the following conditions:

  • Myasthenia gravis
  • Acute narrow-angle glaucoma
  • Severe liver deficiencies (e.g., hepatitis and cirrhosis)
  • Severe sleep apnea
  • Pre-existing respiratory depression
  • Marked neuromuscular respiratory weakness including unstable myasthenia gravis
  • Acute pulmonary insufficiency
  • Chronic psychosis
  • Hypersensitivity or allergy to alprazolam or other drugs in the benzodiazepine class
  • Borderline personality disorder (may induce suicidality and dyscontrol), however correlation does not imply causation, as these behaviors are seen in unmedicated BPD patients.

Overdose

Overdoses can be mild to severe depending on how much of the drug is taken and if any other depressants have been taken. Xanax overdose reflect the central nervous system depresson of the brain and may include one or more of the following symptoms:

  • Somnolence (difficulty staying awake)
  • Mental confusion
  • Respiratory depression
  • Hypotension
  • Impaired motor functions
    • Impaired or absent reflexes
    • Impaired coordination
    • Impaired balance
    • Dizziness
  • Hypoventilation
  • Coma

About 50% of the cases of death involving alprazolam were attributed to combined drug toxicity of alprazolam and another drug, most often cocaine and methadone. Only 1% of such deaths was attributed to alprazolam alone.

Pregnancy

Women who are pregnant or are planning on becoming pregnant should avoid starting alprazolam. If one is currently planning to become pregnant, one should discuss this and all medicines with their obstetrician or other doctor.

Effects on the fetus

It should be considered that the child born of a mother who is receiving benzodiazepines may be at risk of developing withdrawal symptoms from the drug during the postnatal period. Also, neonatal flaccidity and respiratory problems have been reported in children born of mothers who have been receiving benzodiazepines.

Nursing mothers (neonates)

Benzodiazepines, including alprazolam are known to be excreted in human milk. Chronic administration of diazepam to nursing mothers has been reported to cause their infants to become lethargic and to lose weight. As a general rule, nursing should not be undertaken by mothers who use alprazolam.

Geriatric use

Elderly individuals should be cautious in the use of alprazolam due to the possibility of increased susceptibility to side effects, especially loss of coordination and drowsiness.