Moderate
Alprazolam × Cetirizine
Benzodiazepines. Short-to-medium-acting anxiolytics×Second-generation antihistamines
Mechanism
Additive sedation. Cetirizine is a second-generation antihistamine with minimal blood-brain barrier penetration, but the effect adds up with alprazolam.
Symptoms
Drowsiness, sedation, ataxia. Older patients: fall risk. Symptoms appear in the first 1–2 days.
Management
Warn the patient about drowsiness, especially with the first dose. Alternative antihistamines with minimal sedation: fexofenadine or bilastine. In patients needing alprazolam, take antihistamines during the day, not at bedtime.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.