Farmapram (alprazolam) drug use. Neurosis and psychopathies accompanied by fear, anxiety, restlessness; reactive depressive conditions (including those associated with somatic diseases), panic disorder, withdrawal syndrome in patients with alcoholism and drug addiction. Farmapram should be used with caution in patients with liver dysfunction. Alprazolam should be used with caution in patients with impaired renal function. Contraindication for use in children and adolescents under 18 years of age.
For endogenous depression, alprazolam may be used in combination with antidepressants. When using alprazolam in patients with depression, cases of hypomanic and manic states have been noted. Alprazolam should be used with caution in patients with hepatic and/or renal dysfunction. In patients who have not previously taken CNS-affecting drugs, alprazolam is effective at lower doses compared to patients who have received antidepressants, anxiolytics or suffer from chronic alcoholism.
With prolonged use in high doses, addiction and dependence may develop, especially in patients who are prone to drug abuse. With rapid dose reduction or abrupt withdrawal of alprazolam, a withdrawal syndrome is observed, with symptoms ranging from mild dysphoria and insomnia to a severe syndrome with abdominal and skeletal muscle cramps, vomiting, increased sweating, tremors and seizures. Withdrawal syndrome is more common in persons who have received alprazolam for a long period (more than 8-12 weeks).
Other tranquilizers should not be used concomitantly with alprazolam. The safety of using alprazolam in children and adolescents under 18 years of age has not been established. Children, especially younger children, are very sensitive to the CNS depressing effects of benzodiazepines. Alcohol should be avoided during the treatment period. Effect on the ability to drive motor transport and operate machinery. During the treatment period, it is necessary to refrain from potentially hazardous activities requiring increased attention and rapid psychomotor reactions (driving vehicles or working with mechanisms).
Dosing regimen is individual. It is recommended to use the minimum effective dose. The dose is adjusted in the course of treatment depending on the achieved effect and tolerability. If it is necessary to increase the dose, it should be increased gradually, first in the evening and then in the daytime.
The initial dose is 250-500 mcg 3 times/day, with a gradual increase to 4.5 mg/day if necessary.
For elderly or weakened patients the initial dose is 250 mcg 2-3 times/day, maintenance doses are 500-750 mcg/day, if necessary the dose can be increased taking into account tolerance. The alprazolam dose should be withdrawn or reduced gradually, reducing the daily dose by no more than 500 mcg every 3 days; even slower withdrawals may sometimes be necessary.