Ксанакс

Ксанакс – derivative triazolo-benzodiazepine, anxiolytic means (tranquilizer) with myorelaxation, anticonvulsant, sedative and somnolent action.

Form of release and structure

• Tablets (on 10 pieces in planimetric strip packagings, 3 packagings in a pack cardboard);
• Tablets ретард (on 10 pieces in blisters, 3 blisters in a pack cardboard).

Active agent – to alprazola:

• 1 tablet – 0,25 or 0,5 mg;
• 1 tablet ретард – 0,5 or 1 mg.

Indications to use

• The neurotic reactive and depressive and mixed alarming depressions which are followed by a sleep disorder, decrease in mood and vigor, psychomotor agitation, loss of interest to surrounding, disturbance of cognitive activity, somatic complaints, deterioration in appetite, changes of body weight, suicide thoughts (low-value, feeling of fault), etc., including at organic and functional diseases (digestive, cardiovascular, dermatological) at somatic frustration, an alcoholic abstinence syndrome;
• The alarming states and neurosises which are followed by deterioration in a dream, irritability, somatic disturbances, concern, feeling of tension, alarm;
• Attacks of a phobia and panic at patients with an agoraphobia;
• The panic states including which are combined with phobia symptoms.

Contraindications

Absolute:

• Diseases of a thyroid gland (tablet of 0,5 mg);
• Closed-angle glaucoma or predisposition to it;
• Acute respiratory insufficiency;
• Chronic obstructive respiratory diseases with initial manifestations of respiratory insufficiency;
• Myasthenia;
• Shock;
• Coma;
• Acute alcoholic poisonings (the state which are followed by weakening of the vital functions), hypnotic drugs and psychotropic drugs, opioid analgetics;
• Age up to 18 years;
• Pregnancy period (especially I trimester) and lactations;
• Hypersensitivity to drug or other benzodiazepines.

Ксанакс it is not intended for treatment of psychotic depressions (is not effective).

With extra care drug should be used at renal failures and a liver, panic frustration, a suicide mood, heavy depressions.

Route of administration and dosage

Ксанакс it is necessary to accept inside.

The optimum therapeutic dose is established individually for each patient depending on weight of manifestation of symptomatology of a disease and expressiveness of clinical effect of drug.

As a rule, standard doses are sufficient for most of patients. In some cases higher doses are required. Increase should be made with care and gradually. At purpose of a high dose the bigger amount of drug should be accepted before going to bed.

Periodically during treatment it is necessary to revaluate a condition of the patient and, if necessary, to adjust a dose.

In case of development of side effects Ksanaks's dose is reduced.

Treatment of alarming and depressive frustration can last up to 6 months, panic frustration – up to 8 months.

Drug withdrawal should be carried out gradually, reducing a dose no more than by 0,5 mg of times in 3 days, in certain cases – even more slowly.

Tablets
The recommended doses depending on indications:

• Alarm: the initial dose – to 0,25-0,5 mg is 3 times/days, a maintenance dose – 0,5-4 mg/days divided into several receptions;
• Panic frustration: an initial dose – on 0,5 mg 3 times a day or on 0,5-1 mg before going to bed. The maintenance dose is selected individually taking into account expressiveness of clinical effect, increase is carried out no more than on 1 mg of times in 3-4 days. The optimum average dose, according to data of clinical trials, makes 5,7± 2,27 mg/days, use of the maximum daily dose of 10 mg in some cases was required;
• Depression: an initial dose – on 0,5 mg 3 times/days, a maintenance dose – 1,5-4,5 mg/days divided into several receptions.

For elderly people and the weakened patients the initial dose makes on 0,25 mg 2-3 times/days, a maintenance dose – 0,5-0,75 mg/days in stages, if necessary the dose is gradually raised.

Tablets ретард
The recommended doses depending on indications:

• Alarm: an initial dose – 1 mg/days in 1 or 2 receptions, a maintenance dose – 0,5-4 mg/days in 1-2 receptions;
• Panic frustration: an initial dose – on 0,5 mg 2 times/days or on 0,5-1 mg before going to bed. The maintenance dose is selected individually taking into account expressiveness of clinical effect, increase is carried out no more than on 1 mg of times in 3-4 days. The optimum average dose, according to data of clinical trials, makes 5-6 mg/days in 1-2 receptions, use of the maximum daily dose of 10 mg in some cases was required;
• Depression: an initial dose – on 1 mg/days in 1-2 receptions, a maintenance dose – 0,5-4,5 mg/days in 1-2 receptions.

For elderly people the initial dose makes on 0,5-1 mg/days in 1-2 receptions, a maintenance dose – 0,5-1 mg/days, if necessary the dose is gradually raised.

Side effects

• Alimentary system: hypersalivation or dryness in a mouth, locks or diarrhea, a loss of appetite, nausea, vomiting, heartburn, increase in activity of hepatic transaminases and an alkaline phosphatase, an abnormal liver function, jaundice;
• Central nervous system: in an initiation of treatment (especially at elderly people) – the increased fatigue, drowsiness, dizziness, delay of motor and mental reactions, decline in the ability to concentration of attention, instability of gait, a disorientation, an ataxy; seldom – dystonic extrapyramidal reactions (the uncontrollable movements, including an eye), a memory impairment, a headache, an incoordination of movements, a tremor, depression of mood, weakness, confusion of consciousness, euphoria, a dysarthtia, a myasthenia, a depression; in some cases – paradoxical reactions (psychomotor arousing, confusion of consciousness, irritability, hallucinations, aggressive flashes, uneasiness, excitement, sleeplessness, a muscular spasm, fear, suicide bent);
• Cardiovascular system: lowering of arterial pressure, tachycardia;
• System of a hemostasis: agranulocytosis (pharyngalgias, hyperthermia, fever, excessive fatigue or weakness), thrombocytopenia, neutropenia, leukopenia, anemia;
• Urinary system: dysmenorrhea, incontience or ischuria, decrease or increase in a libido, renal failure;
• Endocrine system: change of body weight, disturbance of a menstrual cycle and libido;
• Allergic reactions: skin rash, itch.

Special instructions

In comparison with the patients who are suffering from an alcoholism or earlier receiving anxiolytics or antidepressants at patients who did not accept the drugs influencing the central nervous system earlier to alprazola it is effective in lower doses.

Treatment of endogenous depressions can be performed Ksanaks's combination with antidepressants. With depressions drug can cause development of a maniacal and hypomaniacal state in patients.

At prolonged treatment by high doses of an alprazolam development of accustoming and medicinal dependence, especially at the patients inclined to abuse of medicines is possible.

At sharp cancellation or a bystry dose decline of drug the withdrawal which is shown symptoms of various degree of manifestation – from sleeplessness and a small dysphoria to a heavy syndrome with a tremor, sweating strengthening, vomiting, spasms in a stomach and skeletal muscles, spasms is observed. Most often the withdrawal is noted at the patients receiving Ksanaks is long (more than 8-12 weeks).

During treatment it is necessary to refrain from the use of alcoholic beverages, driving of the car and occupations potentially dangerous types of activity demanding the high speed of reactions and special attention.

Ксанакс it is not necessary to apply along with other tranquilizers.

Medicinal interaction

• Anticonvulsant and psychotropic drugs, ethanol, blockers histamine _{H2 receptors}: the oppressing action of an alprazolam on the central nervous system (CNS) amplifies;
• Antibiotics from group of macroleads: the clearance of an alprazolam decreases;
• Oral hormonal contraceptives: the elimination half-life of an alprazolam increases;
• Dextropropoxyphene: concentration of an alprazolam in a blood plasma because of what perhaps more expressed oppression of TsNS, than in cases of use of an alprazolam with other benzodiazepines increases;
• Digoxin: the risk of development of intoxication by cardiac glycosides increases;
• Imipraminum: its concentration in a blood plasma increases;
• Paroksetin, итраконазол, кетоконазол and, presumably, erythromycin: effects of an alprazolam amplify;
• Fluoxetine, флувоксамин: concentration of an alprazolam in a blood plasma increases, the risk of development of its side effects increases.

Terms and storage conditions

To store in the place, unavailable to children. To observe temperature condition 20-25 ºС.

Period of validity – 3 years.