Cimetidine Alprazolam

Kava rhizome Alprazolam Cimetidine Terazosin Lethargy and disorientation were reported in a patient receiving this triple-drug regimen.f... 

Phenytuin ChlorompbeniwI Phenolnibitol Alprazolam Cimetidine Efavirenz... 

Alprazolam Cimetidine Contraceptives Diazepam Erythromycin Fluoxetine Fluvoxamine Haloperidol Levomepromazine Methylphenidate Paroxetine Perphenazine Tricyclic antidepressants Thioridazine Thyroxine... 

Pourbaix S, Desager JP, Hulhoven R, Smith RB, Harvengt C. Pharmacokinetic consequences of long term coadministration of cimetidine and triazolo-benzodiazepines, alprazolam and triazolam, in healthy subjects. Int J Clin Pharmacol Ther Toxicol 1985 23(8) 447-51. 

Abernethy DR, Greenblatt DJ, DivoU M, Moschitto LJ, Harmatz JS, Shader RI. Interaction of cimetidine with the triazolobenzodiazepines alprazolam and triazolam. Psychopharmacology (Berl) 1983 80(3) 275-8. 

Although a Web site (13) promoting a kava product states that it is safe to use kava in combination with benzodiazepines, a case report (39) suggests otherwise. The combination of kava and alprazolam was believed to be responsible for hospitalizing a 54-year-old man. The patient s semicomatose (lethargic and disoriented) state improved after several hours. He had been taking an undisclosed brand of kava purchased in a health food store in combination with alprazolam for 3 days. Other medications taken included cimetidine and terazosin. 

Clinically important, potentially hazardous interactions with alfuzosin, alprazolam, amphotericin B, anisindione, antacids, aprepitant, astemizole, atorvastatin, bosentan, ciclesonide, cimetidine, clorazepate, conivaptan, cyproterone, dasatinib, dexamethasone, dicumarol, didanosine, eplerenone, erythromycin, ethotoin, fentanyl, fesoterodine, fosamprenavir, fosphenytoin, grapefruit juice, HMG-CoA reductase inhibitors, imatinib, ixabepilone, lapatinib, lopinavir, lovastatin, mephenytoin, methylprednisolone, micafungin, midazolam, nilotinib, pimozide, prednisolone, prednisone, quinidine, rifampin, rimonabant, rivaroxaban, sildenafil, silodosin, simvastatin, sirolimus, solifenacin, temsirolimus, terfenadine, tolvaptan, triazolam, vardenafil, vinblastine, vincristine, warfarin... 

Y. Wang, A. Roy, L. Sun, and C. E. Lau, A double-peak phenomenon in the pharmacokinetics of alprazolam after oral administration. Drug Metab Dispos 27 855-859 (1999). P. Veng Pedersen, Pharmacokinetic analysis by linear system approach I cimetidine bioavailability and second peak phenomenon. J Pharm Sci 70 32-38 (1981). 

Cimetidine Decreased Cl of alprazolam, diazepam, chlordiazepoxide, and clorazepate and increased 6/2... 

Imidazole, 1-methylimidazole, L-histidine, ethylenediamine, caffeine and teophylline were purchased from Kanto Chemicals. Cimetidine, famotidine, omeprazole, thioperamide and dansyl-L-phenylalanine (DNS-Phe) were from Sigma. Histamine (Nacalai Tesque), 3-methylhistamine dihydrochloride (Calbiochem), bis(2,4,6-trichlorophenyl)oxalate (TCPO Tokyo Kasei) and hydrogen peroxide (31% H2O2 Mitsubishi Gas Chemicals) were used as received. Triazolam, estazolam, midazolam and alprazolam were generously supplied from pharmaceutical companies. Special... 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, alprazolam, amitriptyline, amobarbital, amoxapine, antip3rrine, atropine, aza-tadine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bupivacaine, buspirone, butabarbital, butalbital, caffeine, carbamazepine, cetirizine, chlorQrclizine, chlordiazepoxide, chlormezanone, cliloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazeptun, clonidine, clozapine, cocaine, codeine, colchicine, cgrclizine, cy-clobenzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem. 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, alprazolam, amitriptyline, amobarbital, amoxapine, antip5Tine, atenolol, atropine, azatadine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bu-pivacaine, buspirone, butabarbital, caffeine, carbamazepine, cetirizine, chlorcyclizine, chlordiazepoxide, chlormezanone, chloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazepam, clonidine, clozapine, cocaine, codeine, colchicine, cyclizine, qyclo-benzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem, diphenhydramine, diphenidol, diphenoxylate, dipyridamole, disopyramide, dobutamine, doxapram, doxepin, droperidol, encainide, ethidium bromide, ethopropazine, fenoprofen, fentanyl, flavoxate, fluoxetine, fluphenazine, flurazepam, flurbiprofen, fluvoxamine, fu-rosemide, glutethimide, glyburide, guaifenesin, haloperidol, homatropine, hydralazine, hydrochlorothiazide, hydrocodone, hydromorphone, hydroxychloroquine, hydroxyzine, ibuprofen, imipramine, indomethacin, ketoconazole, ketoprofen, ketorolac, labetalol, le-vorphanol, lidocaine, loratadine, lorazepam, lovastatin, loxapine, mazindol, mefenamic acid, meperidine, mephenytoin, mepivacaine, mesoridazine, metaproterenol, methadone, methdilazine, methocarbamol, methotrexate, methotrimeprazine, methoxamine, methyl-dopa, methylphenidate, metoclopramide, metolazone, metoprolol, metronidazole, mida-... 

CYP3A4 alprazolam, calcium channel blockers, cisapride, clarithromycin, cyclosporin A, erythromycin, HIV protease inhibitors, lidocaine, midazolam, simvastatin, terfenadine carbamazepine, dexamethsone, phenobarbital, phenytoin, rifampicin, St John s wort cimetidine, erythromycin, grapefruit juice, HIV protease inhibitors, itraconazole, ketoconazole... 

The combined serum level of diazepam and its active metabolite, des-methyldiazepam, was found to be increased by 75% in 10 patients who took cimetidine 300 mg four times daily for 2 weeks, but reaction times and other motor and intellectual tests remained unaffected. Other reports describe a rise in the plasma levels and/or AUC of diazepam (associated with increased sedation in one report ) due to cimetidine, and generalised incoordination has also been described in one individual. Cimetidine also raises the serum levels of adinazolam, alprazolam, chlordiazepoxide, clobazam, clorazepate, flu-razepam, nitrazepam, and triazolam, > > > and reduces the clearance of bromazepam. ... 

Cimetidine inhibits the liver enzymes concerned with the metabolism of diazepam, alprazolam, chlordiazepoxide, clomethiazole, clorazepate, flu-razepam, nitrazepam, triazolam, and zaleplon. As a result their clearance from the body is reduced and their serum levels rise. 

The manufacturers of sertindole contraindicate the concurrent use of cimetidine, diltiazem, erythromycin, itraconazole, ketoco-nazole, terfenadine and verapamil because of an increased risk of cardiac arrhythmias. Carbamazepine and phenytoin reduce plasma sertindole levels whereas fluoxetine and paroxetine increase them. No clinically relevant interactions occur with alprazolam, antacids, food or tobacco smoking. 

A 54-year-old man taking kava, alprazolam, cimeti-dine, and terazosin was reported to have lethargy and disorientation (Almeida and Grimsley 1996). Cimetidine has been shown to slow the metabolism of alprazolam, a benzodiazepine that may cause sleepiness, dizziness, and confusion if overdosed (Greenblatt and Wright 1993). 

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