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Drug interactions between prednisone and Xanax

Results for the following 2 drugs:
prednisone
Xanax (alprazolam)

Interactions between your drugs

Minor

alprazolam ↔ prednisone

Applies to:Xanax (alprazolam) and prednisone

Certain corticosteroids may decrease the plasma concentration of some benzodiazepines. Limited data are available for midazolam and triazolam. The mechanism is related to induction of hepatic cytochrome P450 enzymes responsible for benzodiazepine metabolism. The clinical significance may depend on the dosage and duration of corticosteroid therapy and be of greater importance with oral administration of benzodiazepines.

References

  1. Villikka K, Kivisto KT, Neuvonen PJ "The effect of dexamethasone on the pharmacokinetics of triazolam." Pharmacol Toxicol 83 (1998): 135-8
  2. Nakajima M, Suzuki T, Sasaki T, Yokoi T, Hosoyamada A, Yamamoto T, Kuroiwa Y "Effects of chronic administration of glucocorticoid on midazolam pharmacokinetics in humans." Ther Drug Monit 21 (1999): 507-13

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Drug and food interactions

Moderate

alprazolam food

Applies to: Xanax (alprazolam)

GENERALLY AVOID: The pharmacologic activity of oral midazolam, triazolam, and alprazolam may be increased if taken after drinking grapefruit juice. The proposed mechanism is CYP450 3A4 enzyme inhibition. In addition, acute alcohol ingestion may potentiate CNS depression and other CNS effects of many benzodiazepines. Tolerance may develop with chronic ethanol use. The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition. Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.

MANAGEMENT: The manufacturer recommends that grapefruit juice should not be taken with oral midazolam. Patients taking triazolam or alprazolam should be monitored for excessive sedation. Alternatively, the patient could consume orange juice which does not interact with these drugs. Patients should be advised to avoid alcohol during benzodiazepine therapy.

References

  1. Hukkinen SK, Varhe A, Olkkola KT, Neuvonen PJ "Plasma concentrations of triazolam are increased by concomitant ingestion of grapefruit juice." Clin Pharmacol Ther 58 (1995): 127-31
  2. Kupferschmidt HHT, Ha HR, Ziegler WH, Meier PJ, Krahenbuhl S "Interaction between grapefruit juice and midazolam in humans." Clin Pharmacol Ther 58 (1995): 20-8
  3. "Product Information. Valium (diazepam)." Roche Laboratories, Nutley, NJ.
  4. Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther 68 (2000): 468-77
  5. "Product Information. Xanax (alprazolam)." Pharmacia and Upjohn, Kalamazoo, MI.
  6. "Grapefruit juice interactions with drugs." Med Lett Drugs Ther 37 (1995): 73-4
  7. "Product Information. Halcion (triazolam)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 7 references

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Therapeutic duplication warnings

No therapeutic duplications were found for your selected drugs.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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