Farmapram 2mg is indicated in the treatment of anxiety: Anxiety with symptoms of depression and anguish crisis (panic attack) states of simple anxiety and associated with other conditions such as: chronic phase of alcoholic withdrawal organic or functional disorders (somatization).
Farmapram 2mg is a triazolobenzodiazepine. The exact mechanism of action has not been established so far. Clinically all benzodiazepines cause a central nervous system depression dose-dependent ranging from minimal alterations to hypnosis.
After oral administration, alprazolam is rapidly absorbed, reaching serum peaks between 1 and 2 hours after administration.
The elimination half-life of alprazolam is from 1 to 15 hours with urine being the main route of excretion. Like the other benzodiazepines, alprazolam crosses the placental barrier and is excreted in breast milk.
Farmapram 2mg is contraindicated in patients with known sensitivity to benzodiazepines, angle-closure glaucoma, and myasthenia gravis.
Farmapram 2mg causes CNS depression so that patients who are the administration should be warned that the product depresses the osteotendinous reflexes, so caution should be exercised when handling vehicles or precision machinery.
In some patients who receive recommended doses or high doses of alprazolam for relatively short periods (from 1 week to 4 months) seizures have been reported when the dose is rapidly decreased or if there is abrupt treatment suppression. For this reason the dose of alprazolam should be reduced or gradually withdrawn.
In elderly or debilitated patients it is recommended that the dose to be used is the lowest and most effective in order to avoid the development of ataxia or oversedation.
To discontinue treatment with alprazolam in accordance with good medical practice, the dose should be reduced slowly. It is suggested that the daily dose be decreased at a rate of 0.5 mg every 3 days.
Some patients may require a lower dose reduction.
Symptoms have been reported for suppression following a rapid or abrupt discontinuation of benzodiazepines including alprazolam.
These have been classified from mild dysphoria and insomnia to a major syndrome which may include abdominal cramps, vomiting, sweating, fear and seizures.
The administration of alprazolam to severely depressed or potentially suicidal patients should be done with appropriate precautions.
With the administration of Farmapram 2mg should observe the usual precautions in patients compromised in their renal or hepatic function.
It is not recommended in patients with primary diagnosis of schizophrenia.
Although no withdrawal effects have been observed in patients who were abruptly suppressed after 6 months of therapy, such abstinence symptoms have been reported to result from the abrupt withdrawal of other benzodiazepines. Individuals with an inclination to abuse drugs such as alcoholics or drug addicts should be closely monitored if they receive treatment with benzodiazepines in view of their predisposition to habituation and dependence.
RESTRICTIONS OF USE DURING PREGNANCY AND LACTATION
The use of this product in pregnancy increases the risk of congenital malformations. As a general rule, mothers are advised not to feed the breast while they are being treated with al-
prazolam since like the rest of the benzodiazepines alprazolam is excreted in human milk.
The safety and efficacy of alprazolam in patients younger than 18 years has not been established yet.
SECONDARY AND ADVERSE REACTIONS
Side effects if they occur are usually observed at the beginning of therapy and usually disappear with the suppression of the treatment or with the adjustment of the dose. The most common side effect with alprazolam was drowsiness.
Less common effects were: stunning, blurred vision, incoordination, gastrointestinal symptoms, autonomic manifestations, headaches, depression, insomnia, fear of body weight variations, and memory / amnesia disturbances. As with other benzodiazepines, paradoxical reactions may occur, such as stimulation, agitation, difficulty concentrating, confusion, hallucinations or other effects on behavior.
Oral. The optimal dose of alprazolam should be individualized based on the severity of the symptoms and the individual response of the patient.
The average dose covers the needs of the majority of patients; in the case of patients requiring higher doses, these must be carefully established (in order to avoid side effects) and administered by first increasing the dose in the afternoon or evening than in the more active hours.
In general, patients who have not previously received treatment with psychotropics required lower doses than those who have taken minor tranquilizers, antidepressants, hypnotics or those with a history of chronic alcoholism.
It is recommended, as a general principle, the use of the lowest dose to start in elderly or debilitated patients, to avoid the risk of developing sedation or ataxia.
Usual starting dose: 0.25 to 0.50 mg administered 3 times a day.
Usual dose in treatment: 0.50 to 4.0 mg daily: administer in divided doses.
Geriatric or debilitated patients:
Usual starting dose: 0.25 mg.
Usual dose in treatment: 0.50 to 0.75 mg daily in divided doses, which can be increased if necessary and tolerated.
If side effects occur, the dose should be reduced.
Alterations related to crisis of anguish:
Start with 0.50 to 1.0 mg provided at bedtime.
The dose should be adjusted according to the patient’s response. The dose adjustments should be in increments of no more than 1 mg every three or four days.
Additional doses can be provided until a dosing schedule of three or four times a day is reached. The average dose in the clinical studies was 5.7 ± 2.27 mg with cases of patients that required a maximum of 10 mg. newspapers.
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