inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.levorphanolalprazolam and levorphanol both increase sedation. Use Caution/Monitor.lisdexamfetaminealprazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lofepraminealprazolam and lofepramine both increase sedation. Use Caution/Monitor.alprazolam increases levels of lofepramine by decreasing metabolism. Use Caution/Monitor.lofexidinealprazolam and lofexidine both increase sedation. Use Caution/Monitor.lomitapidealprazolam increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.loprazolamalprazolam and loprazolam both increase sedation. Use Caution/Monitor.lorazepamalprazolam and lorazepam both increase sedation. Use Caution/Monitor.lorlatiniblorlatinib will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lormetazepamalprazolam and lormetazepam both increase sedation. Use Caution/Monitor.loxapinealprazolam and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledalprazolam and loxapine inhaled both increase sedation. Use Caution/Monitor.lumefantrinelumefantrine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lurasidonelurasidone, alprazolam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilinealprazolam and maprotiline both increase sedation. Use Caution/Monitor.marijuanamarijuana will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.alprazolam and marijuana both increase sedation. Use Caution/Monitor.melatoninalprazolam and melatonin both increase sedation. Use Caution/Monitor.meperidinealprazolam and meperidine both increase sedation. Use Caution/Monitor.meprobamatealprazolam and meprobamate both increase sedation. Use Caution/Monitor.metaproterenolalprazolam increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaxalonealprazolam and metaxalone both increase sedation. Use Caution/Monitor.methadonealprazolam and methadone both increase sedation. Use Caution/Monitor.methamphetaminealprazolam increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methocarbamolalprazolam and methocarbamol both increase sedation. Use Caution/Monitor.methylenedioxymethamphetaminealprazolam increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methylprednisolonemethylprednisolone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.metronidazolemetronidazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.miconazole vaginalmiconazole vaginal will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.midazolamalprazolam and midazolam both increase sedation. Use Caution/Monitor.midazolam intranasalalprazolam will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.midazolam intranasal will increase the level or effect of alprazolam by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midodrinealprazolam increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mifepristonemifepristone will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.mirtazapinealprazolam and mirtazapine both increase sedation. Use Caution/Monitor.mitotanemitotane decreases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.modafinilalprazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphinealprazolam and morphine both increase sedation. Use Caution/Monitor.motherwortalprazolam and motherwort both increase sedation. Use Caution/Monitor.moxonidinealprazolam and moxonidine both increase sedation. Use Caution/Monitor.nabilonealprazolam and nabilone both increase sedation. Use Caution/Monitor.nalbuphinealprazolam and nalbuphine both increase sedation. Use Caution/Monitor.nelfinavirnelfinavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nevirapinenevirapine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nifedipinenifedipine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nilotinibnilotinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nirmatrelvir/ritonavirnirmatrelvir/ritonavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider lowering alprazolam dosing when coadministered with nirmatrelvir/ritonavirnorepinephrinealprazolam increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylinealprazolam and nortriptyline both increase sedation. Use Caution/Monitor.olanzapinealprazolam and olanzapine both increase sedation. Use Caution/Monitor.oliceridineoliceridine, alprazolam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. 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.ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider decreasing alprazolam dose based on clinical responseopium tincturealprazolam and opium tincture both increase sedation. Use Caution/Monitor.orphenadrinealprazolam and orphenadrine both increase sedation. Use Caution/Monitor.oxazepamalprazolam and oxazepam both increase sedation. Use Caution/Monitor.oxcarbazepineoxcarbazepine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.oxycodonealprazolam and oxycodone both increase sedation. Use Caution/Monitor.oxymorphonealprazolam and oxymorphone both increase sedation. Use Caution/Monitor.paliperidonealprazolam and paliperidone both increase sedation. Use Caution/Monitor.papaveretumalprazolam and papaveretum both increase sedation. Use Caution/Monitor.papaverinealprazolam and papaverine both increase sedation. Use Caution/Monitor.pentazocinealprazolam and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalpentobarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pentobarbital and alprazolam both increase sedation. Use Caution/Monitor.perampanelperampanel and alprazolam both increase sedation. Use Caution/Monitor.perphenazinealprazolam and perphenazine both increase sedation. Use Caution/Monitor.phendimetrazinealprazolam increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenobarbitalphenobarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.phenobarbital and alprazolam both increase sedation. Use Caution/Monitor.phenterminealprazolam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrinealprazolam increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine POalprazolam increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .phenytoinphenytoin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pholcodinealprazolam and pholcodine both increase sedation. Use Caution/Monitor.pimozidealprazolam and pimozide both increase sedation. Use Caution/Monitor.pirbuterolalprazolam increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.posaconazoleposaconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.prednisoneprednisone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pregabalinpregabalin, 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.primidoneprimidone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.primidone and alprazolam both increase sedation. Use Caution/Monitor.prochlorperazinealprazolam and prochlorperazine both increase sedation. Use Caution/Monitor.promethazinepromethazine and alprazolam both increase sedation. Use Caution/Monitor.propofolpropofol and alprazolam both increase sedation. Use Caution/Monitor.propylhexedrinealprazolam increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylinealprazolam and protriptyline both increase sedation. Use Caution/Monitor.quazepamalprazolam and quazepam both increase sedation. Use Caution/Monitor.quetiapinealprazolam and quetiapine both increase sedation. Use Caution/Monitor.quinupristin/dalfopristinquinupristin/dalfopristin will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ramelteonalprazolam and ramelteon both increase sedation. Use Caution/Monitor.remimazolamremimazolam, alprazolam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibribociclib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifapentinerifapentine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.risperidonealprazolam and risperidone both increase sedation. Use Caution/Monitor.ritonavirritonavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rucaparibrucaparib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.rufinamiderufinamide will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.salmeterolalprazolam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.scullcapalprazolam and scullcap both increase sedation. Use Caution/Monitor.secobarbitalsecobarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.secobarbital and alprazolam both increase sedation. Use Caution/Monitor.sevofluranesevoflurane and alprazolam both increase sedation. Use Caution/Monitor.shepherd's pursealprazolam and shepherd's purse both increase sedation. Use Caution/Monitor.sofosbuvir/velpatasvirsofosbuvir/velpatasvir increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Velpatasvir inhibits CYP3A4. Caution if coadministered with drugs with narrow therapeutics indexes.stiripentolstiripentol, alprazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.stiripentol, alprazolam. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.sufentanilalprazolam and sufentanil both increase sedation. Use Caution/Monitor.suvorexantsuvorexant and alprazolam both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessarytapentadolalprazolam and tapentadol both increase sedation. Use Caution/Monitor.tazemetostattazemetostat will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.alprazolam will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimattecovirimat will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.teduglutideteduglutide increases levels of alprazolam by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.temazepamalprazolam and temazepam both increase sedation. Use Caution/Monitor.terbutalinealprazolam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thioridazinealprazolam and thioridazine both increase sedation. Use Caution/Monitor.thiothixenealprazolam and thiothixene both increase sedation. Use Caution/Monitor.topiramatetopiramate will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.alprazolam and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadolalprazolam and tramadol both increase sedation. Use Caution/Monitor.trazodonealprazolam and trazodone both increase sedation. Use Caution/Monitor.triazolamalprazolam and triazolam both increase sedation. Use Caution/Monitor.triclofosalprazolam and triclofos both increase sedation. Use Caution/Monitor.trifluoperazinealprazolam and trifluoperazine both increase sedation. Use Caution/Monitor.trimipraminealprazolam and trimipramine both increase sedation. Use Caution/Monitor.triprolidinetriprolidine and alprazolam both increase sedation. Use Caution/Monitor.verapamilverapamil will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.voriconazolevoriconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.xylometazolinealprazolam increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbinealprazolam increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.zafirlukastzafirlukast will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ziconotidealprazolam and ziconotide both increase sedation. Use Caution/Monitor.ziprasidonealprazolam and ziprasidone both increase sedation. Use Caution/Monitor.zotepinealprazolam and zotepine both increase sedation. Use Caution/Monitor.Minor (20)acetazolamideacetazolamide will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.anastrozoleanastrozole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.brimonidinebrimonidine increases effects of alprazolam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.ciprofloxacinciprofloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.cyclophosphamidecyclophosphamide will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.esomeprazoleesomeprazole increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.eucalyptusalprazolam and eucalyptus both increase sedation. Minor/Significance Unknown.fleroxacinfleroxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.gemifloxacingemifloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.green teagreen tea decreases effects of alprazolam by pharmacodynamic antagonism. Minor/Significance Unknown. Caffeine component of green tea may decrease sedative effects of benzodiazepines.larotrectiniblarotrectinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.levofloxacinlevofloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.lithiumalprazolam increases levels of lithium by decreasing renal clearance. Minor/Significance Unknown.moxifloxacinmoxifloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.ofloxacinofloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.omeprazoleomeprazole increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.rifabutinrifabutin decreases levels of alprazolam by increasing metabolism. Minor/Significance Unknown.sagealprazolam and sage both increase sedation. Minor/Significance Unknown.vinpocetinealprazolam increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).zolpidemzolpidem, alprazolam. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.abametapirSerious - Use Alternative (1)abametapir will increase