Interactions between xanax(alprazolam) and Posaconazole (posaconazole)
alprazolam and posaconazole (Major Drug-Drug)
ADJUST DOSE: Coadministration with posaconazole may significantly increase the plasma concentrations and pharmacologic effects of benzodiazepines that are primarily metabolized by CYP450 3A4. The mechanism is increased bioavailability and/or decreased clearance due to inhibition of intestinal and hepatic CYP450 3A4 by posaconazole. According to product labeling, pretreatment with posaconazole (200 mg tablets once a day for 10 days) increased the systemic exposure (AUC) of a single 0.05 mg/kg intravenous dose of midazolam by 83%. A greater effect is expected with oral midazolam. The interaction is subject to a high degree of interpatient variability.
MANAGEMENT: The benzodiazepine dose may require reduction during concomitant administration with posaconazole. Monitoring for increased benzodiazepine effects is recommended, and the dosage adjusted as necessary. Alternatively, benzodiazepines that are not metabolized by CYP450 3A4 (e.g., lorazepam, oxazepam, temazepam) may be considered in patients requiring posaconazole treatment.
