Drug Interaction Report

Methylxanthines may antagonize the sedative effects of benzodiazepines. Aminophylline in particular has been demonstrated to attenuate the sedative effects of diazepam. The mechanism of this interaction may be related to competitive binding to intracerebral adenosine receptors. One study demonstrated that alprazolam serum concentrations were significantly lower in patients receiving chronic theophylline therapy than in patients not receiving theophylline. Clinical and laboratory monitoring is warranted if these agents are given concurrently. Patients receiving this combination should be monitored for adequate response to the benzodiazepine.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.