ModerateBenzodiazepines. Short-to-medium-acting anxiolytics×Central α2-adrenergic agonist
Updated · Methodology
Mechanism
Additive CNS depression and hypotension. Clonidine is a central α2-agonist with sedative effect; alprazolam is a GABAergic sedative.
Symptoms
Sedation, fatigue, slowed reactions, impaired coordination. In older patients: fall and fracture risk. Driving and operating machinery: accident risk. Pronounced morning hypotension and bradycardia possible.
Management
On starting the combination, begin both at minimal doses with time-separated dosing (e.g. clonidine in the morning, alprazolam at bedtime). Avoid the combination in older patients — fall risk. In anxiety disorders with hypertension, alternative: a beta-blocker (metoprolol) plus buspirone.
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.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Clonidine hydrochloride tablet (Alembic Pharmaceuticals Limited) – Prescribing Information section 7 (2012)– ; DailyMed setid 88a8db46-0fc9-48cd-b7cc-ac9c9cdea100