NAV

Alprazolam

Identification

Summary

Alprazolamis a triazolobenzodiazepine with intermediate onset commonly used to treat panic disorders and generalized anxiety in addition to anxiety associated with depression.

Brand Names
Niravam, Xanax
Generic Name
Alprazolam
DrugBank Accession Number
DB00404
Background

Alprazolam is a triazolobenzodiazepine indicated for the treatment of anxiety and panic disorders.18,19It is mainly metabolized by CYP3As and so is contraindicated with CYP3A inhibitors like ketoconazole and itraconazole.18,19Benzodiazepine treatment should be stopped gradually by tapering down a patient's dose to avoid withdrawal symptoms.4Alprazolam's adverse effects are generally related to the sedation it can cause.4Alprazolam has been mixed with alcohol as a drug of abuse to potentiate the sedative effects of the drug which may lead to coma and death.4Alprazolam was given FDA approval on October 16, 1981.14

Type
Small Molecule
Groups
Approved, Illicit, Investigational
Structure
 3D
Similar Structures
Weight
Average: 308.765
Monoisotopic: 308.082874143
Chemical Formula
C17H13ClN4
Synonyms
  • 8-Chloro-1-methyl-6-phenyl-4H-s-triazolo(4,3-a)(1,4)benzodiazepine
  • Alprazolam
External IDs
  • AZ-002
  • TUS-1
  • U 31,889
  • U-31,889
  • U-31889

Pharmacology

Indication

Alprazolam is indicated for the acute treatment of generalized anxiety disorder in adults.18Alprazolam is also indicated, either as a standard or extended-release formulation, for the treatment of panic disorder with or without agoraphobia in adults.18,19

Alprazolam may also be prescribed off-label for insomnia, premenstrual syndrome, and depression.3

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Associated Conditions
Contraindications & Blackbox Warnings
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Pharmacodynamics

Alprazolam is a benzodiazepine that binds γ-aminobutyric acid (GABA) type-A receptors (GABAARs) to enhance their inhibitory effect on neurotransmission, specifically in the brain.18,19Concomitant use with opioids may result in profound sedation, respiratory depression, coma, and death; patients taking benzodiazepines and opioids concurrently may require lower doses of one or both medications, depending on their clinical situation. Patients with pre-existing impaired respiratory function are at increased risk of adverse effects including death during treatment with benzodiazepines. In addition, due to its CNS depressant effects, patients taking alprazolam should avoid operating heavy machinery or driving and should avoid other CNS depressants such as alcohol. As with other benzodiazepines, alprazolam carries a risk of abuse, misuse, and addiction, which is higher in predisposed individuals and may require strict monitoring. Cessation of therapy may result in acute or protracted withdrawal symptoms, which may be life-threatening; the patient dose should be gradually tapered whenever discontinuation or reduced dosage are necessary. Newborns born to mothers using alprazolam later in pregnancy may suffer from sedation and withdrawal symptoms. As CYP3A is required for the initial step in alprazolam metabolism, alprazolam is contraindicated in patients taking strong CYP3A inhibitors, such as ketoconazole and itraconazole; milder CYP3A inhibitors still necessitate alprazolam dosage adjustments. Lastly, benzodiazepines may have negative effects, such as panic disorders, increased suicide incidence, and episodes of mania/hypomania, in patients suffering from depression.4,7,18,19

Mechanism of action

Neurotransmission relies on excitatory and inhibitory signalling. γ-aminobutyric acid (GABA) type-A receptors (GABAARs) are members of the pentameric ligand-gated ion channel (PLGIC) superfamily located synaptically and perisynaptically to mediate phasic inhibition and extrasynaptically to mediate tonic inhibition. GABAARs comprise a variety of subunits from a homologous family whose members are named based on sequence identity as one of α1-6, β1-3, γ1-3, δ, ε, θ, π, and ρ1-3. Each subunit possesses an extracellular (ECD), transmembrane (TMD), and intracellular (ICD) domain; inter-subunit interfaces are the primary points of neurotransmitter and modulator binding, described by coordination of the principal (+) and complementary (-) sites in each subunit. Binding of GABA to GABAARs induces pore opening, rapid flow of chloride ions, and synaptic hyperpolarization, which in turn manifests as an inhibitory signal.8,9

The most prevalent GABAARsin vivoare the α1β2γ2 receptors, which contain both GABA (β+/α-) and benzodiazepine (BZD, α+/γ-) binding sites in the intersubunit interfaces of the relevant subunits.8,9,10In general, any receptors containing an αx/γzinterface, where x = 1-3,5 and z = 1-3, have potential high-affinity BZD binding sites, although small sequence differences between subunits may alter binding affinity to individual molecules. The α4 and α6 subunits, in which an otherwise conserved histidine is replaced by arginine, do not bind traditional BZD ligands such as diazepam and hence are considered "diazepam-insensitive".8,9,10GABA binding results in a series of conformational changes in the ECDs of GABAAR β subunits, "locking" each to its neighbouring α- interface. The binding of alprazolam in the high-affinity BZD site stabilizes the α+/γ- interface and facilitates the conformational changes that lead to pore opening, hence functioning as a positive allosteric modulator.11

The exact manner in which GABAAR allosteric modulation mediates the therapeutic and unwanted effects of benzodiazepines remains unclear.3,4Earlier studies suggested that the primary factor was the α subunit composition, with α1-containing receptors mediating the sedative effects, α2/3-containing receptors the anxiolytic effects, and α5-containing receptors the memory effects of benzodiazepines.12More recent studies suggest a more complex set of factors including subunit composition, physiological location, neuronal circuit, and nerve cell type.13To further complicate matters, there may be up to five distinct BZD binding sites on GABAARs, with site 1 corresponding to the classical high-affinity α+/γ- interface. The effects of binding at sites 2-4 are not fully understood and likely impart greater complexity to benzodiazepine pharmacological action.9,10

Target Actions Organism
AGABA(A) Receptor
positive allosteric modulator
 Humans
AGABA(A) Receptor Benzodiazepine Binding Site
ligand
 Humans
Absorption

Alprazolam administered orally is rapidly absorbed in the gastrointestinal tract, reaching Cmaxin about 1.8 (1-2) hours. Absorption is high, resulting in an oral bioavailability of 84-91%. A 1 mg oral dose results in a Cmaxof 12-22 μg/L.2,18

The extended-release formulation of alprazolam (XANAX XR) has similar absorption, bioavailability, and pharmacokinetics as the standard release, with the exception that the Tmaxis ~10 hours compared to 1-2 hours. Temporal dosing alters these parameters, with Cmaxincreasing by 30% and Tmaxdecreasing by one hour when dosed at night as opposed to in the morning.19

Food has an effect on alprazolam absorption; a high-fat meal up to two hours before dosing increases the Cmaxby ~25% and either a reduction (food consumed immediately prior to dosing) or increase (food consumed after dosing) of ~1/3 in Tmax. Neither the AUC nor half-life are appreciably affected by eating.19

Volume of distribution

Alprazolam has a volume of distribution following oral administration of 0.8-1.3L/kg.2Alprazolam crosses the blood-brain barrier.4

Protein binding

Alprazolam is ~80% protein-bound in serum.18,19The majority of this protein binding is to serum albumin.1,18,19Alprazolam is also bound to alpha1-acid glycoprotein with low frequency.2

Metabolism

Alprazolam is metabolized to less effective metabolites by various CYPs including CYP3A4, CYP3A5, CYP3A7, and CYP2C9.5,6,16,18,19The majority of alprazolam metabolism is mediated by hydroxylation via CYP3As.5,6,2,16,18,194-hydroxyalprazolam has 20% the binding affinity of the parent drug, alpha-hydroxyalprazolam has 66% the affinity, and the benzophenone metabolite has <1% the affinity.2,18,19

Hover over products below to view reaction partners

Route of elimination

Alprazolam is mainly eliminated in the urine.18,19A large portion of the dose is eliminated as unmetabolized alprazolam.2<10% of the dose is eliminated as alpha-hydroxy-alprazolam and 4-hydroxy-alprazolam.2

Half-life

Alprazolam has a mean plasma elimination half-life of 11.2 hours in healthy patients (range 6.3-26.9 hours).18The mean half-life is 16.3 hours (range 9.0-26.9 hours) in the elderly, 21.8 hours (range 9.9-40.4 hours) in obese patients, and 19.7 hours (range 5.8-65.3 hours) in patients with alcoholic liver disease.18The half-life is 25% higher in Asian patients compared to Caucasians.18Other studies have shown the half-life to be 9-16h.2The extended-release formulation has a half-life of 10.7-15.8 hours in healthy adult patients.19

Clearance

A 0.8 mg oral dose of alprazolam had a clearance of 0.90 ± 0.21 mL/min/kg, which increased to 2.13 ± 0.54 mL/min/kg when coadministered with the strong CYP3A4 inducer carbamazepine.18,19Other studies have demonstrated a clearance of 0.70-1.5mL/min/kg.2

Adverse Effects
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Toxicity

Alprazolam overdose can present as sleepiness, confusion, poor coordination, slow reflexes, coma, and death.18,19Taking alprazolam with alcohol lowers the threshold for overdose.18,19Patients should have their respiration, pulse, and blood pressure monitored.18,19Patients can be treated by gastric lavage and intravenous fluids.18,19. If hypotension occurs, patients may be treated with vasopressors.18,19In known, or suspected overdoses, patients can be given the benzodiazepine receptor antagonistflumazenilin addition to other methods of management.18,19

Oral LD50 in rats is 331-2171mg/kg.Label

Pathways
Not Available
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Interactions

Drug InteractionsLearn More" title="" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction
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1,2-Benzodiazepine The risk or severity of adverse effects can be increased when Alprazolam is combined with 1,2-Benzodiazepine.
Abacavir Alprazolam may decrease the excretion rate of Abacavir which could result in a higher serum level.
Abametapir The serum concentration of Alprazolam can be increased when it is combined with Abametapir.
Abatacept The metabolism of Alprazolam can be increased when combined with Abatacept.
Abiraterone The metabolism of Alprazolam can be decreased when combined with Abiraterone.
Acalabrutinib The metabolism of Alprazolam can be decreased when combined with Acalabrutinib.
Aceclofenac Aceclofenac may decrease the excretion rate of Alprazolam which could result in a higher serum level.
Acemetacin Acemetacin may decrease the excretion rate of Alprazolam which could result in a higher serum level.
Acetaminophen The metabolism of Alprazolam can be decreased when combined with Acetaminophen.
Acetazolamide The metabolism of Alprazolam can be decreased when combined with Acetazolamide.
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Food Interactions
  • Avoid alcohol. Alcohol may potentiate the CNS depressant effects of this drug.
  • Avoid grapefruit products.
  • Limit caffeine intake.
  • Take with or without food. Food increases the Cmax of extended release alprazolam by 25%, but the AUC and half life are not affected.

Products

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Product Images
International/Other Brands
Alplax/Alprazolan/Alpronax/Alprox/Alviz/Cassadan/Esparon/Ralozam/Restyl/Solanax/Staccato alprazolam (Alexza)/Tafil/Trankimazin/Tranquinal/Xanor
Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image
Alprazolam Tablet 1 mg Oral Jamp Pharma Corporation Not applicable Not applicable Canada flag
Alprazolam Tablet, extended release 3 mg/1 Oral Zydus Pharmaceuticals Usa, Inc. 2008-10-28 Not applicable US flag
Alprazolam Tablet 0.25 mg Oral Sanis Health Inc 2010-04-30 2021-12-01 Canada flag
Alprazolam Tablet, extended release 0.5 mg/1 Oral Zydus Pharmaceuticals Usa, Inc. 2008-10-28 Not applicable US flag
Alprazolam Tablet 0.5 mg Oral Jamp Pharma Corporation Not applicable Not applicable Canada flag
Alprazolam Tablet, extended release 2 mg/1 Oral Zydus Pharmaceuticals Usa, Inc. 2008-10-28 Not applicable US flag
Alprazolam Tablet 2 mg Oral Jamp Pharma Corporation Not applicable Not applicable Canada flag
Alprazolam Tablet 0.25 mg Oral Jamp Pharma Corporation Not applicable Not applicable Canada flag
Alprazolam Tablet 0.50 mg Oral Sanis Health Inc 2010-04-30 2021-12-01 Canada flag
Alprazolam Tablet, extended release 1 mg/1 Oral Zydus Pharmaceuticals Usa, Inc. 2008-10-28 Not applicable US flag
Generic Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image
Alprazolam Tablet 2 mg/1 Oral Remedy Repack 2014-05-13 2015-09-23 US flag
Alprazolam Tablet .5 mg/1 Oral Cardinal Health 2007-12-03 2015-02-28 US flag
Alprazolam Tablet 1 mg/1 Oral Mc Kesson Contract Packaging 2011-10-17 2017-09-30 US flag
Alprazolam Tablet 0.25 mg/1 Oral American Health Packaging 2013-08-26 2019-06-30 US flag
Alprazolam Tablet 1 mg/1 Oral St. Marys Medical Park Pharmacy 2016-04-01 Not applicable US flag
Alprazolam Tablet 1 mg/1 Oral St. Mary's Medical Park Pharmacy 2019-02-20 Not applicable US flag
Alprazolam Tablet 0.25 mg/1 Oral Aurobindo Pharma Limited 2015-07-31 Not applicable US flag
Alprazolam Tablet 1 mg/1 Oral McKesson Corporation dba SKY Packaging 1995-12-29 Not applicable US flag
Alprazolam Tablet 0.25 mg/1 Oral Rising Pharmaceuticals, Inc. 2017-11-07 Not applicable US flag
Alprazolam Tablet, orally disintegrating 2 mg/1 Oral Par Pharmaceutical, Inc. 2009-01-09 Not applicable US flag
Unapproved/Other Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image
Gabazolamine Alprazolam(0.25 mg/1)+Choline(125mg/1) Kit Oral Physician Therapeutics Llc 2011-07-07 Not applicable US flag
Gabazolamine-0.5 Alprazolam(0.5 mg/1)+Choline(125mg/1) Kit Oral Physician Therapeutics Llc 2011-07-07 Not applicable US flag
Sentrazolam AM Alprazolam(0.25 mg/1)+Choline(250 mg/1) Kit Oral Physician Therapeutics Llc 2011-07-07 Not applicable US flag

Categories

ATC Codes
N05BA12 — Alprazolam
Drug Categories
Chemical TaxonomyProvided byClassyfire
Description
This compound belongs to the class of organic compounds known as 1,2,4-triazolo[4,3-a][1,4]benzodiazepines. These are aromatic compounds containing a 1,4-benzodiazepine fused to and sharing a nitrogen atom with a 1,2,4-triazole ring.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Benzodiazepines
Sub Class
1,4-benzodiazepines
Direct Parent
1,2,4-triazolo[4,3-a][1,4]benzodiazepines
Alternative Parents
Benzene and substituted derivatives/Aryl chlorides/Triazoles/Heteroaromatic compounds/Ketimines/Propargyl-type 1,3-dipolar organic compounds/Azacyclic compounds/Organopnictogen compounds/Organochlorides/Hydrocarbon derivatives
Substituents
1,2,4-triazole/1,2,4-triazolo[4,3-a][1,4]benzodiazepine/Aromatic heteropolycyclic compound/Aryl chloride/Aryl halide/Azacycle/Azole/Benzenoid/Heteroaromatic compound/Hydrocarbon derivative
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
organochlorine compound, triazolobenzodiazepine (CHEBI:2611)
Affected organisms
  • 人类和其他哺乳动物

Chemical Identifiers

UNII
YU55MQ3IZY
CAS number
28981-97-7
InChI Key
VREFGVBLTWBCJP-UHFFFAOYSA-N
InChI
InChI=1S/C17H13ClN4/c1-11-20-21-16-10-19-17(12-5-3-2-4-6-12)14-9-13(18)7-8-15(14)22(11)16/h2-9H,10H2,1H3
IUPAC Name
12-chloro-3-methyl-9-phenyl-2,4,5,8-tetraazatricyclo[8.4.0.0^{2,6}]tetradeca-1(10),3,5,8,11,13-hexaene
SMILES
CC1=NN=C2CN=C(C3=CC=CC=C3)C3=C(C=CC(Cl)=C3)N12

References

Synthesis Reference

海丝特,有机,Jr .);我们。Patent 3,681,343; August 1,1972; assigned to The Upjohn Company. Hester, J.B., Jr.; US.Patent 3,781,289; December 25,1973;assigned to The Upjohn Company. Hester, J.B., Jr.; U S . Patent 3,709898; January 9,1973; assigned to The Upjohn Company.
General References
  1. Dangkoob F, Housaindokht MR, Asoodeh A, Rajabi O, Rouhbakhsh Zaeri Z, Verdian Doghaei A: Spectroscopic and molecular modeling study on the separate and simultaneous bindings of alprazolam and fluoxetine hydrochloride to human serum albumin (HSA): with the aim of the drug interactions probing. Spectrochim Acta A Mol Biomol Spectrosc. 2015 Feb 25;137:1106-19. doi: 10.1016/j.saa.2014.08.149. Epub 2014 Oct 7. [Article]
  2. Greenblatt DJ, Wright CE: Clinical pharmacokinetics of alprazolam. Therapeutic implications. Clin Pharmacokinet. 1993 Jun;24(6):453-71. doi: 10.2165/00003088-199324060-00003. [Article]
  3. George TT, Tripp J: Alprazolam . [Article]
  4. Verster JC, Volkerts ER: Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature. CNS Drug Rev. 2004 Spring;10(1):45-76. [Article]
  5. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [Article]
  6. Williams JA, Ring BJ, Cantrell VE, Jones DR, Eckstein J, Ruterbories K, Hamman MA, Hall SD, Wrighton SA: Comparative metabolic capabilities of CYP3A4, CYP3A5, and CYP3A7. Drug Metab Dispos. 2002 Aug;30(8):883-91. [Article]
  7. Ait-Daoud N, Hamby AS, Sharma S, Blevins D: A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med. 2018 Jan/Feb;12(1):4-10. doi: 10.1097/ADM.0000000000000350. [Article]
  8. Scott S, Aricescu AR: A structural perspective on GABAA receptor pharmacology. Curr Opin Struct Biol. 2019 Feb;54:189-197. doi: 10.1016/j.sbi.2019.03.023. Epub 2019 May 23. [Article]
  9. Olsen RW: GABAA receptor: Positive and negative allosteric modulators. Neuropharmacology. 2018 Jul 1;136(Pt A):10-22. doi: 10.1016/j.neuropharm.2018.01.036. Epub 2018 Jan 31. [Article]
  10. Sigel E, Ernst M: The Benzodiazepine Binding Sites of GABAA Receptors. Trends Pharmacol Sci. 2018 Jul;39(7):659-671. doi: 10.1016/j.tips.2018.03.006. Epub 2018 Apr 30. [Article]
  11. Masiulis S, Desai R, Uchanski T, Serna Martin I, Laverty D, Karia D, Malinauskas T, Zivanov J, Pardon E, Kotecha A, Steyaert J, Miller KW, Aricescu AR: GABAA receptor signalling mechanisms revealed by structural pharmacology. Nature. 2019 Jan;565(7740):454-459. doi: 10.1038/s41586-018-0832-5. Epub 2019 Jan 2. [Article]
  12. Rowlett JK, Platt DM, Lelas S, Atack JR, Dawson GR: Different GABAA receptor subtypes mediate the anxiolytic, abuse-related, and motor effects of benzodiazepine-like drugs in primates. Proc Natl Acad Sci U S A. 2005 Jan 18;102(3):915-20. doi: 10.1073/pnas.0405621102. Epub 2005 Jan 11. [Article]
  13. Engin E, Benham RS, Rudolph U: An Emerging Circuit Pharmacology of GABAA Receptors. Trends Pharmacol Sci. 2018 Aug;39(8):710-732. doi: 10.1016/j.tips.2018.04.003. Epub 2018 Jun 11. [Article]
  14. FDA Approved Drug Products: Xanax [Link]
  15. FDA Pregnancy Categories [Link]
  16. Flockhart Table of Drug Interactions [Link]
  17. FDA Approved Drug Products: XANAX (Alprazolam) tablets [Link]
  18. FDA Approved Drug Products: XANAX (alprazolam) tablets [Link]
  19. FDA Approved Drug Products: XANAX XR (alprazolam) extended-release tablets [Link]
Human Metabolome Database
HMDB0014548
KEGG Drug
D00225
KEGG Compound
C06817
PubChem Compound
2118
PubChem Substance
46507078
ChemSpider
2034
BindingDB
50001728
RxNav
596
ChEBI
2611
ChEMBL
CHEMBL661
ZINC
ZINC000000000903
Therapeutic Targets Database
DAP000239
PharmGKB
PA448333
PDBe Ligand
08H
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
PDRhealth
PDRhealth Drug Page
Wikipedia
Alprazolam
PDB Entries
3u5j/6huo
FDA label
Download (381 KB)
MSDS
Download (47.3 KB)

Clinical Trials

Clinical TrialsLearn More" title="" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count
4 Completed Basic Science Driving Behavior 1
4 Completed Basic Science Healthy Subjects (HS) 1
4 Completed Diagnostic Anxiety Disorders 1
4 Completed Other Psychomotor Impairment 1
4 Completed Treatment Anxiety 2
4 Completed Treatment Generalized Anxiety Disorder 1
4 Completed Treatment Generalized Anxiety Disorder/Panic Disorder 1
4 Completed Treatment Inferior Alveolar Nerve Block Failure 1
4 Completed Treatment Panic Disorder 2
4 Recruiting Treatment Anxiety Disease/Gynecologic Diseases 1

Pharmacoeconomics

Manufacturers
  • Roxane laboratories inc
  • Actavis elizabeth llc
  • Amneal pharmaceuticals ny llc
  • Apotex inc
  • Barr laboratories inc
  • Corepharma llc
  • Impax laboratories inc
  • Mylan pharmaceuticals inc
  • Sandoz inc
  • Teva pharmaceuticals usa
  • 复古调药的als llc
  • Watson laboratories inc florida
  • Zydus pharmaceuticals usa inc
  • Pharmacia and upjohn
  • Par pharmaceutical inc
  • Schwarz pharma inc
  • Alphapharm party ltd
  • Dava international inc
  • Ivax pharmaceuticals inc sub teva pharmaceuticals usa
  • Sun pharma global inc
  • Teva pharmaceuticals usa inc
  • Watson laboratories inc
  • Pharmacia and upjohn co
Packagers
  • Actavis Group
  • Aidarex Pharmacuticals LLC
  • Alphapharm Party Ltd.
  • Amerisource Health Services Corp.
  • Amneal Pharmaceuticals
  • Apotheca Inc.
  • A-S Medication Solutions LLC
  • AzurPharma Inc.
  • Barr Pharmaceuticals
  • Bryant Ranch Prepack
  • Cardinal Health
  • Caremark LLC
  • Centaur Pharmaceuticals Pvt Ltd.
  • Cima Laboratories Inc.
  • Corepharma LLC
  • DAVA Pharmaceuticals
  • Direct Dispensing Inc.
  • Dispensing Solutions
  • Diversified Healthcare Services Inc.
  • Emcure Pharmaceuticals Ltd.
  • Eon Labs
  • Global Pharmaceuticals
  • Greenstone LLC
  • H.J. Harkins Co. Inc.
  • Heartland Repack Services LLC
  • Innoviant Pharmacy Inc.
  • Ivax Pharmaceuticals
  • Kaiser Foundation Hospital
  • Keltman Pharmaceuticals Inc.
  • Lake Erie Medical and Surgical Supply
  • Liberty Pharmaceuticals
  • Major Pharmaceuticals
  • Mckesson Corp.
  • Medisca Inc.
  • Medvantx Inc.
  • Murfreesboro Pharmaceutical Nursing Supply
  • Mylan
  • Novopharm Ltd.
  • Nucare Pharmaceuticals Inc.
  • Palmetto Pharmaceuticals Inc.
  • Par Pharmaceuticals
  • PD-Rx Pharmaceuticals Inc.
  • Pfizer Inc.
  • Pharmacia Inc.
  • Pharmedix
  • Physicians Total Care Inc.
  • Preferred Pharmaceuticals Inc.
  • Prepak Systems Inc.
  • Qualitest
  • Rebel Distributors Corp.
  • Redpharm Drug
  • Remedy Repack
  • Rising Pharmaceuticals
  • Roxane Labs
  • Sandhills Packaging Inc.
  • Sandoz
  • Southwood Pharmaceuticals
  • Stat Rx Usa
  • Sun Pharmaceutical Industries Ltd.
  • Teva Pharmaceutical Industries Ltd.
  • UDL Laboratories
  • Ultratab Labs Inc.
  • Va Cmop Dallas
  • Vintage Pharmaceuticals Inc.
  • Zydus Pharmaceuticals
Dosage Forms
Form Route Strength
Tablet
Solution, concentrate Oral 1 mg/1mL
Tablet Oral
Tablet Oral .25 mg/1
Tablet Oral .5 mg/1
Tablet Oral 0.25 mg/1
Tablet Oral 0.5 mg/1
Tablet Oral 1 mg/1
Tablet Oral 1.00 mg/1
Tablet Oral 2 mg/1
Tablet Oral 2.00 mg/1
Tablet, extended release Oral 0.5 mg/1
Tablet, extended release Oral 1 mg/1
Tablet, extended release Oral 2 mg/1
Tablet, extended release Oral 3 mg/1
Tablet 0.5 MG
Tablet 1.0 MG
Solution / drops Oral 0.75 MG/ML
Tablet 0.50 MG
Solution / drops Oral 750 MICROGRAMMI/1ML
Solution / drops Oral 750 MICROGRAMMI/ML
Tablet 1 mg
Tablet Sublingual 0.5 mg
Solution Oral 1 mg
Tablet Oral 0.5 mg
Tablet, orally disintegrating Oral 0.25 mg/1
Tablet, orally disintegrating Oral 0.5 mg/1
Tablet, orally disintegrating Oral 1 mg/1
Tablet, orally disintegrating Oral 2 mg/1
Tablet Oral .25 mg
Tablet Oral .5 mg
Tablet Oral 0.25 mg / tab
Tablet Oral 0.5 mg / tab
Kit Oral
Tablet Oral 0.125 mg
Tablet 0.25 MG
Capsule
Solution / drops Oral
Tablet Oral 0.25 MG
Tablet Oral 0.50 MG
Tablet Oral 1 MG
Tablet, extended release Oral 0.5 MG
Tablet, extended release Oral 1 MG
Tablet, extended release Oral 2 MG
Solution Oral 0.75 mg
Tablet Sublingual
Tablet, film coated Oral 0.25 mg
Tablet, film coated Oral 0.5 mg
Tablet Oral 2 mg
Tablet, extended release Oral
平板电脑、糖涂层 Oral 0.5 mg
平板电脑、糖涂层 Oral 1 mg
平板电脑、糖涂层 Oral 2 mg
平板电脑、糖涂层 Oral 3 mg
Tablet Sublingual 1 mg
Prices
Unit description Cost Unit
ALPRAZolam Intensol 1 mg/ml Concentrate 30ml Bottle 67.03USD bottle
Niravam 2 mg Dispersible Tablet 8.53USD dispersible tablet
Xanax xr 3 mg tablet 7.25USD tablet
Xanax XR 3 mg 24 Hour tablet 7.1USD tablet
Niravam 2 mg tablet 6.86USD tablet
Niravam 1 mg Dispersible Tablet 5.42USD dispersible tablet
Xanax xr 2 mg tablet 4.84USD tablet
Xanax XR 2 mg 24 Hour tablet 4.73USD tablet
Niravam 0.5 mg Dispersible Tablet 4.2USD dispersible tablet
Niravam 1 mg tablet 4.04USD tablet
Xanax 2 mg tablet 3.82USD tablet
ALPRAZolam 3 mg 24 Hour tablet 3.67USD tablet
Xanax XR 1 mg 24 Hour tablet 3.64USD tablet
Xanax xr 1 mg tablet 3.64USD tablet
Niravam 0.25 mg Dispersible Tablet 3.45USD dispersible tablet
Niravam 0.5 mg tablet 3.02USD tablet
Xanax XR 0.5 mg 24 Hour tablet 3.01USD tablet
Xanax xr 0.5 mg tablet 2.93USD tablet
ALPRAZolam 2 mg 24 Hour tablet 2.53USD tablet
Niravam 0.25 mg tablet 2.43USD tablet
ALPRAZolam 1 mg 24 Hour tablet 2.33USD tablet
Xanax 1 mg tablet 2.29USD tablet
Alprazolam 1 mg/ml oral conc 2.23USD ml
Xanax 0.5 mg tablet 1.3USD tablet
Alprazolam 2 mg tablet 1.22USD tablet
Xanax 0.25 mg tablet 1.09USD tablet
ALPRAZolam 0.5 mg 24 Hour tablet 1.07USD tablet
Alprazolam 1 mg tablet 0.78USD tablet
Alprazolam 0.5 mg tablet 0.67USD tablet
Alprazolam 0.25 mg tablet 0.55USD tablet
Apo-Alpraz 0.5 mg Tablet 0.1USD tablet
Mylan-Alprazolam 0.5 mg Tablet 0.1USD tablet
Novo-Alprazol 0.5 mg Tablet 0.1USD tablet
Apo-Alpraz 0.25 mg Tablet 0.08USD tablet
Mylan-Alprazolam 0.25 mg Tablet 0.08USD tablet
Novo-Alprazol 0.25 mg Tablet 0.08USD tablet
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Patents
Patent Number Pediatric Extension Approved Expires (estimated) Region
US6221392 No 2001-04-24 2018-04-09 US flag
US6024981 No 2000-02-15 2018-04-09 US flag

Properties

State
Solid
Experimental Properties
Property Value Source
melting point (°C) 228-229.5 °C 海丝特,有机,Jr .);我们。Patent3,681,343;8月1日1972; assigned to The Upjohn Company. Hester, J.B., Jr.; US.Patent3,781,289; December 25,1973;assigned to The Upjohn Company. Hester, J.B., Jr.; U S . Patent 3,709898; January 9,1973; assigned t o The Upjohn Company.
Predicted Properties
Property Value Source
Water Solubility 0.0324 mg/mL ALOGPS
logP 2.23 ALOGPS
logP 3.02 Chemaxon
logS -4 ALOGPS
pKa (Strongest Acidic) 18.2 Chemaxon
pKa (Strongest Basic) 5.01 Chemaxon
Physiological Charge 0 Chemaxon
Hydrogen Acceptor Count 3 Chemaxon
Hydrogen Donor Count 0 Chemaxon
Polar Surface Area 43.07 Å2 Chemaxon
Rotatable Bond Count 1 Chemaxon
Refractivity 98.88 m3·mol-1 Chemaxon
Polarizability 32.22 Å3 Chemaxon
Number of Rings 4 Chemaxon
Bioavailability 1 Chemaxon
Rule of Five Yes Chemaxon
Ghose Filter Yes Chemaxon
Veber's Rule No Chemaxon
MDDR-like Rule No Chemaxon
Predicted ADMET Features
Property Value Probability
Human Intestinal Absorption + 1.0
Blood Brain Barrier + 0.9794
Caco-2 permeable + 0.8867
P-glycoprotein substrate Non-substrate 0.5099
P-glycoprotein inhibitor I Non-inhibitor 0.7301
P-glycoprotein inhibitor II Inhibitor 0.8354
Renal organic cation transporter Inhibitor 0.7688
CYP450 2C9 substrate Non-substrate 0.7907
CYP450 2D6 substrate Non-substrate 0.9164
CYP450 3A4 substrate Substrate 0.7353
CYP450 1A2 substrate Inhibitor 0.8758
CYP450 2C9 inhibitor Inhibitor 0.8076
CYP450 2D6 inhibitor Non-inhibitor 0.8137
CYP450 2C19 inhibitor Inhibitor 0.6519
CYP450 3A4 inhibitor Non-inhibitor 0.6308
CYP450 inhibitory promiscuity High CYP Inhibitory Promiscuity 0.8913
Ames test Non AMES toxic 0.8957
Carcinogenicity Non-carcinogens 0.6779
Biodegradation Not ready biodegradable 1.0
Rat acute toxicity 2.3717 LD50, mol/kg Not applicable
hERG inhibition (predictor I) Weak inhibitor 0.973
hERG inhibition (predictor II) Non-inhibitor 0.8733
ADMET data is predicted usingadmetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
Spectrum Spectrum Type Splash Key
Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available
Mass Spectrum (Electron Ionization) MS splash10-0kdi-4792000000-9f1cdda14e36000955d3
Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS Not Available
LC-MS/MS Spectrum - LC-ESI-qTof , Positive LC-MS/MS Not Available
LC-MS/MS Spectrum - LC-ESI-QTOF , positive LC-MS/MS splash10-0a59-0079000000-e4c35fb4df41aa5cc62e
MS/MS Spectrum - , positive LC-MS/MS splash10-0bt9-0169000000-0e6779728f3bdec2acf1
MS/MS Spectrum - , positive LC-MS/MS splash10-0a4i-0910000000-9efa6a8a3dea17fc1ce7

Targets

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Details 1.GABA(A) Receptor (Protein Group)
Kind
Protein group
Organism
Humans
Pharmacological action
Yes
Actions
Positive allosteric modulator
Curator comments
GABA (A)受体是pentameric(即comprising 5 subunit proteins) and therefore has a multitude of potential isoforms. The above target is a collection of all possible GABA(A) subunits that may participate in the formation of the pentameric receptor and is not meant to imply direct a drug-protein interaction for each individual subunit.
General Function
Inhibitory extracellular ligand-gated ion channel activity
Specific Function
Component of the heteropentameric receptor for GABA, the major inhibitory neurotransmitter in the vertebrate brain. Functions also as histamine receptor and mediates cellular responses to histamine...
Components:
Name UniProt ID
γ-氨基丁酸受体亚基alpha - P14867
Gamma-aminobutyric acid receptor subunit alpha-2 P47869
Gamma-aminobutyric acid receptor subunit alpha-3 P34903
Gamma-aminobutyric acid receptor subunit alpha-4 P48169
Gamma-aminobutyric acid receptor subunit alpha-5 P31644
Gamma-aminobutyric acid receptor subunit alpha-6 Q16445
Gamma-aminobutyric acid receptor subunit beta-1 P18505
Gamma-aminobutyric acid receptor subunit beta-2 P47870
Gamma-aminobutyric acid receptor subunit beta-3 P28472
Gamma-aminobutyric acid receptor subunit delta O14764
Gamma-aminobutyric acid receptor subunit epsilon P78334
Gamma-aminobutyric acid receptor subunit gamma-1 Q8N1C3
Gamma-aminobutyric acid receptor subunit gamma-2 P18507
Gamma-aminobutyric acid receptor subunit gamma-3 Q99928
Gamma-aminobutyric acid receptor subunit pi O00591
Gamma-aminobutyric acid receptor subunit theta Q9UN88
References
  1. 里斯期J, Cloyd而言J,盖茨J,柯林斯S: Benzodiazepines in epilepsy: pharmacology and pharmacokinetics. Acta Neurol Scand. 2008 Aug;118(2):69-86. doi: 10.1111/j.1600-0404.2008.01004.x. Epub 2008 Mar 31. [Article]
  2. Verster JC, Volkerts ER: Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature. CNS Drug Rev. 2004 Spring;10(1):45-76. [Article]
  3. Zhu S, Noviello CM, Teng J, Walsh RM Jr, Kim JJ, Hibbs RE: Structure of a human synaptic GABAA receptor. Nature. 2018 Jul;559(7712):67-72. doi: 10.1038/s41586-018-0255-3. Epub 2018 Jun 27. [Article]
  4. Sigel E, Steinmann ME: Structure, function, and modulation of GABA(A) receptors. J Biol Chem. 2012 Nov 23;287(48):40224-31. doi: 10.1074/jbc.R112.386664. Epub 2012 Oct 4. [Article]
Details 2.GABA (A)苯二氮受体结合位点(防ein Group)
Kind
Protein group
Organism
Humans
Pharmacological action
Yes
Actions
Ligand
Curator comments
Benzodiazepines modulate GABA(A) function by binding at the interface between alpha (α) and gamma (γ) subunits. Of the 6 α-subunits, only 4 (α-1, -2, -3, and -5) participate in the formation of this binding site. The above target is a collection of all α- and γ-subunits that are known to participate in the formation of the benzodiazepine binding site.
General Function
Inhibitory extracellular ligand-gated ion channel activity
Specific Function
Component of the heteropentameric receptor for GABA, the major inhibitory neurotransmitter in the vertebrate brain. Functions also as histamine receptor and mediates cellular responses to histamine...
Components:
Name UniProt ID
γ-氨基丁酸受体亚基alpha - P14867
Gamma-aminobutyric acid receptor subunit alpha-2 P47869
Gamma-aminobutyric acid receptor subunit alpha-3 P34903
Gamma-aminobutyric acid receptor subunit alpha-5 P31644
Gamma-aminobutyric acid receptor subunit gamma-1 Q8N1C3
Gamma-aminobutyric acid receptor subunit gamma-2 P18507
Gamma-aminobutyric acid receptor subunit gamma-3 Q99928
References
  1. Sigel E, Steinmann ME: Structure, function, and modulation of GABA(A) receptors. J Biol Chem. 2012 Nov 23;287(48):40224-31. doi: 10.1074/jbc.R112.386664. Epub 2012 Oct 4. [Article]
  2. Zhu S, Noviello CM, Teng J, Walsh RM Jr, Kim JJ, Hibbs RE: Structure of a human synaptic GABAA receptor. Nature. 2018 Jul;559(7712):67-72. doi: 10.1038/s41586-018-0255-3. Epub 2018 Jun 27. [Article]

Enzymes

Details 1.Cytochrome P450 3A7
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Oxygen binding
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP3A7
Uniprot ID
P24462
Uniprot Name
Cytochrome P450 3A7
分子量
57525.03 Da
References
  1. Flockhart Table of Drug Interactions [Link]
Details 2.Cytochrome P450 3A4
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
分子量
57342.67 Da
References
  1. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [Article]
  2. Williams JA, Ring BJ, Cantrell VE, Jones DR, Eckstein J, Ruterbories K, Hamman MA, Hall SD, Wrighton SA: Comparative metabolic capabilities of CYP3A4, CYP3A5, and CYP3A7. Drug Metab Dispos. 2002 Aug;30(8):883-91. [Article]
  3. Flockhart Table of Drug Interactions [Link]
  4. FDA Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers [Link]
  5. FDA Approved Drug Products: XANAX (Alprazolam) tablets [Link]
Details 3.Cytochrome P450 2C9
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2C9
Uniprot ID
P11712
Uniprot Name
Cytochrome P450 2C9
分子量
55627.365 Da
References
  1. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. [Article]
Details 4.Cytochrome P450 3A5
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Oxygen binding
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP3A5
Uniprot ID
P20815
Uniprot Name
Cytochrome P450 3A5
分子量
57108.065 Da
References
  1. Allqvist A, Miura J, Bertilsson L, Mirghani RA: Inhibition of CYP3A4 and CYP3A5 catalyzed metabolism of alprazolam and quinine by ketoconazole as racemate and four different enantiomers. Eur J Clin Pharmacol. 2007 Feb;63(2):173-9. doi: 10.1007/s00228-006-0230-z. Epub 2007 Jan 3. [Article]
  2. Park JY, Kim KA, Park PW, Lee OJ, Kang DK, Shon JH, Liu KH, Shin JG: Effect of CYP3A5*3 genotype on the pharmacokinetics and pharmacodynamics of alprazolam in healthy subjects. Clin Pharmacol Ther. 2006 Jun;79(6):590-9. doi: 10.1016/j.clpt.2006.02.008. [Article]
  3. Hirota N, Ito K, Iwatsubo T, Green CE, Tyson CA, Shimada N, Suzuki H, Sugiyama Y: In vitro/in vivo scaling of alprazolam metabolism by CYP3A4 and CYP3A5 in humans. Biopharm Drug Dispos. 2001 Mar;22(2):53-71. [Article]
  4. Flockhart Table of Drug Interactions [Link]

Carriers

Details 1.Serum albumin
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Binder
General Function
Toxic substance binding
Specific Function
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name
ALB
Uniprot ID
P02768
Uniprot Name
Serum albumin
分子量
69365.94 Da
References
  1. Dangkoob F, Housaindokht MR, Asoodeh A, Rajabi O, Rouhbakhsh Zaeri Z, Verdian Doghaei A: Spectroscopic and molecular modeling study on the separate and simultaneous bindings of alprazolam and fluoxetine hydrochloride to human serum albumin (HSA): with the aim of the drug interactions probing. Spectrochim Acta A Mol Biomol Spectrosc. 2015 Feb 25;137:1106-19. doi: 10.1016/j.saa.2014.08.149. Epub 2014 Oct 7. [Article]
Details 2.alpha1-acid glycoprotein (Protein Group)
Kind
Protein group
Organism
Humans
Pharmacological action
Unknown
Actions
Binder
General Function
Not Available
Specific Function
Functions as transport protein in the blood stream. Binds various ligands in the interior of its beta-barrel domain. Also binds synthetic drugs and influences their distribution and availability in...
Components:
Name UniProt ID
Alpha-1-acid glycoprotein 1 P02763
Alpha-1-acid glycoprotein 2 P19652
References
  1. Greenblatt DJ, Wright CE: Clinical pharmacokinetics of alprazolam. Therapeutic implications. Clin Pharmacokinet. 1993 Jun;24(6):453-71. doi: 10.2165/00003088-199324060-00003. [Article]

Drug created at June 13, 2005 13:24 / Updated at April 26, 2023 07:53