MajorBenzodiazepines. Short-to-medium-acting anxiolytics×Class III antiarrhythmic
Updated · Methodology
Mechanism
Dronedarone is a strong CYP3A4 inhibitor, the main alprazolam metabolic route. Alprazolam plasma levels may rise 2- to 4-fold. Deep sedation, fall risk in older patients.
Symptoms
Deep sedation, drowsiness, ataxia. Older patients: fall and fracture risk. Symptoms appear within 1–2 days.
Management
During dronedarone therapy, halve alprazolam or use lorazepam/oxazepam (glucuronidated, no CYP3A4 dependence).
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: Multaq (dronedarone) prescribing information (2020)– ; DailyMed setid 7fa41601-7fb5-4155-8e50-2ae903f0d2d6