sedation. Use Caution/Monitor.diphenhydramineMonitor Closely (1)diphenhydramine and alprazolam both increase sedation. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)alprazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.dipipanoneMonitor Closely (1)alprazolam and dipipanone both increase sedation. Use Caution/Monitor.disulfiramMonitor Closely (1)disulfiram increases levels of alprazolam by decreasing metabolism. Use Caution/Monitor.dobutamineMonitor Closely (1)alprazolam increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dopamineMonitor Closely (1)alprazolam increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dopexamineMonitor Closely (1)alprazolam increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dosulepinMonitor Closely (1)alprazolam and dosulepin both increase sedation. Use Caution/Monitor.doxepinMonitor Closely (1)alprazolam and doxepin both increase sedation. Use Caution/Monitor.doxylamineMonitor Closely (1)alprazolam and doxylamine both increase sedation. Use Caution/Monitor.dronedaroneMonitor Closely (1)dronedarone will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.droperidolMonitor Closely (1)alprazolam and droperidol both increase sedation. Use Caution/Monitor.duvelisibMonitor Closely (1)duvelisib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect ofefavirenzMonitor Closely (1)efavirenz will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.elagolixMonitor Closely (1)elagolix will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.elvitegravir/cobicistat/emtricitabine/tenofovir DFMonitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; consider benzodiazepine dose reduction.encorafenibMonitor Closely (1)encorafenib, alprazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.ephedrineMonitor Closely (1)alprazolam increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrineMonitor Closely (1)alprazolam increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrine racemicMonitor Closely (1)alprazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.erythromycin baseSerious - Use Alternative (1)erythromycin base will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin ethylsuccinateSerious - Use Alternative (1)erythromycin ethylsuccinate will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin lactobionateSerious - Use Alternative (1)erythromycin lactobionate will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin stearateSerious - Use Alternative (1)erythromycin stearate will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.esketamine intranasalMonitor Closely (1)esketamine intranasal, alprazolam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.esomeprazoleMinor (1)esomeprazole increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.estazolamMonitor Closely (1)alprazolam and estazolam both increase sedation. Use Caution/Monitor.ethanolMonitor Closely (1)alprazolam and ethanol both increase sedation. Use Caution/Monitor.ethinylestradiolMonitor Closely (1)ethinylestradiol will increase the level or effect of alprazolam by Mechanism: decreasing metabolism. Use Caution/Monitor. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.etomidateMonitor Closely (1)etomidate and alprazolam both increase sedation. Use Caution/Monitor.etravirineMonitor Closely (1)etravirine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.eucalyptusMinor (1)alprazolam and eucalyptus both increase sedation. Minor/Significance Unknown.fedratinibMonitor Closely (1)fedratinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.fenfluramineMonitor Closely (1)alprazolam increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fexinidazoleSerious - Use Alternative (1)fexinidazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.finerenoneMonitor Closely (1)alprazolam will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.fleroxacinMinor (1)fleroxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.flibanserinMonitor Closely (1)alprazolam and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.fluconazoleMonitor Closely (1)fluconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fludrocortisoneMonitor Closely (1)fludrocortisone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fluphenazineMonitor Closely (1)alprazolam and fluphenazine both increase sedation. Use Caution/Monitor.flurazepamMonitor Closely (1)alprazolam and flurazepam both increase sedation. Use Caution/Monitor.fluvoxamineMonitor Closely (1)fluvoxamine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.formoterolMonitor Closely (1)alprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fosamprenavirMonitor Closely (1)fosamprenavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fosaprepitantMonitor Closely (1)fosaprepitant will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fosphenytoinMonitor Closely (1)fosphenytoin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.gabapentinMonitor Closely (1)gabapentin, alprazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.gabapentin enacarbilMonitor Closely (1)gabapentin enacarbil, alprazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.ganaxoloneMonitor Closely (1)alprazolam and ganaxolone both increase sedation. Use Caution/Monitor.gemifloxacinMinor (1)gemifloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.grapefruitMonitor Closely (1)grapefruit will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.green teaMinor (1)green tea decreases effects of alprazolam by pharmacodynamic antagonism. Minor/Significance Unknown. Caffeine component of green tea may decrease sedative effects of benzodiazepines.griseofulvinMonitor Closely (1)griseofulvin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.haloperidolMonitor Closely (1)alprazolam and haloperidol both increase sedation. Use Caution/Monitor.hyaluronidaseMonitor Closely (1)hyaluronidase, alprazolam. Other (see comment). Use Caution/Monitor. Comment: Drug combination has been found to be incompatible.hydrocodoneSerious - Use Alternative (1)hydrocodone, alprazolam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.hydrocortisoneMonitor Closely (1)hydrocortisone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.hydromorphoneMonitor Closely (1)alprazolam and hydromorphone both increase sedation. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine and alprazolam both increase sedation. Use Caution/Monitor.idelalisibSerious - Use Alternative (1)idelalisib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substratesiloperidoneMonitor Closely (2)alprazolam and iloperidone both increase sedation. Use Caution/Monitor. iloperidone increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.imipramineMonitor Closely (1)alprazolam and imipramine both increase sedation. Use Caution/Monitor.indinavirMonitor Closely (1)indinavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.isavuconazonium sulfateMonitor Closely (1)alprazolam will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.isoniazidMonitor Closely (1)isoniazid will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.isoproterenolMonitor Closely (1)alprazolam increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.istradefyllineMonitor Closely (1)istradefylline will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.itraconazoleSerious - Use Alternative (1)itraconazole increases levels of alprazolam by decreasing metabolism. Avoid or Use Alternate Drug.ivosidenibSerious - Use Alternative (1)ivosidenib will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.ketamineMonitor Closely (1)ketamine and alprazolam both increase sedation. Use Caution/Monitor.ketoconazoleContraindicated (1)ketoconazole increases levels of alprazolam by decreasing metabolism. Contraindicated.ketotifen, ophthalmicMonitor Closely (1)alprazolam and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.lapatinibMonitor Closely (1)lapatinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.larotrectinibMinor (1)larotrectinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.lasmiditanMonitor Closely (1)lasmiditan, alprazolam. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.lemborexantMonitor Closely (2)alprazolam will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification. lemborexant, alprazolam. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.lenacapavirMonitor Closely (1)lenacapavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.letermovirMonitor Closely (1)letermovir increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.levalbuterolMonitor Closely (1)alprazolam increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.levofloxacinMinor (1)levofloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.levoketoconazoleContraindicated (2)levoketoconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. levoketoconazole increases levels of alprazolam by decreasing metabolism. Contraindicated.levonorgestrel oral/ethinylestradiol/ferrous bisglycinateMonitor Closely (1)levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will increase the level or effect of alprazolam by decreasing metabolism. Use Caution/Monitor. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.levorphanolMonitor Closely (1)alprazolam and levorphanol both increase sedation. Use Caution/Monitor.lisdexamfetamineMonitor Closely (1)alprazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lithiumMinor (1)alprazolam increases levels of lithium by decreasing renal clearance. Minor/Significance Unknown.lofepramineMonitor Closely (2)alprazolam increases levels of lofepramine by decreasing metabolism. Use Caution/Monitor. alprazolam and lofepramine both increase sedation. Use Caution/Monitor.lofexidineMonitor Closely (1)alprazolam and lofexidine both increase sedation. Use Caution/Monitor.lomitapideMonitor Closely (1)alprazolam increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.lonafarnibSerious - Use Alternative (2)alprazolam will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown. lonafarnib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.lopinavirSerious - Use Alternative (1)lopinavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.loprazolamMonitor Closely (1)alprazolam and loprazolam both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (1)alprazolam and lorazepam both increase sedation. Use Caution/Monitor.lorlatinibMonitor Closely (1)lorlatinib will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lormetazepamMonitor Closely (1)alprazolam and lormetazepam both increase sedation. Use Caution/Monitor.loxapineMonitor Closely (1)alprazolam and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)alprazolam and loxapine inhaled both increase sedation. Use Caution/Monitor.lumefantrineMonitor Closely (1)lumefantrine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme