Alprazolam
También conocido como: Xanax XR · Niravam · Alprazolam Intensol · D65 MT · U 31889 · alprazolamum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For treatment of canine anxiety disorders | 0.01-0.1 mg/kg PO as needed for panic, not to exceed 4 mg/dog/day. Start with 1-2 mg (total dose) for a medium-sized dog. | PO | prn | — | 🌎 NA |
| For separation anxiety | 0.25 mg-2 mg (total dose) once daily to three times daily PO. | PO | q8-24h | — | 🌎 NA |
| For storm phobias | 0.02-0.4 mg/kg PO q4h as needed | PO | q4h | — | 🌎 NA |
| For storm phobias (adjunct) | 0.02 mg/kg PO as needed one hour before anticipated storm and every 4 hours as needed | PO | q4h | — | 🌎 NA |
| For phobias, night waking | 0.01-0.1 mg/kg or 0.25-2 mg (total dose) per dog PO q6-12h PO | PO | q6-12h | — | 🌎 NA |
| For acute anxiety | 0.05-0.1 mg/kg PO prn or three times a day. Administer 30-60 minutes prior to trigger event. | PO | prn or q8h | — | 🌎 NA |
| Anxiolysis and fear-related disorders | 0.01-0.1 mg/kg | PO | prn up to q6h | As needed | 🌍 EU |
- For storm phobias: Helps to minimize impact of experiencing a severe storm
- For storm phobias (adjunct): Used as an adjunct after behavior modification and prior clomipramine treatment
- Anxiolysis and fear-related disorders: Titrate up or down to the minimum effective dose. Best given ~30 mins before a fear-inducing event.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For treatment of feline anxiety disorders | 0.125-0.25 mg/kg PO q12h (Start at 0.125 mg/kg PO) | PO | q12h | — | 🌎 NA |
| For refractory house soiling | 0.1 mg/kg or 0.125-0.25 mg (total dose) per cat PO q8-12h | PO | q8-12h | — | 🌎 NA |
| For urine marking | 0.05-0.2 mg/kg PO q12-24h | PO | q12-24h | — | 🌎 NA |
| For fears/phobias/anxieties | 0.125-0.25 mg (total dose) PO once to three times a day. | PO | q8-24h | — | 🌎 NA |
| For acute anxiety | 0.05 mg/kg PO prn or three times a day. Administer 30-60 minutes prior to trigger event. | PO | prn or q8h | — | 🌎 NA |
| Anxiolysis and urine spraying | 0.125-0.25 mg/kg | PO | prn up to bid | As needed | 🌍 EU |
- Anxiolysis and urine spraying: Doses as low as 0.25 mg/cat q8-12h and as high as 0.6 mg/kg have been reported. Titrate down to minimum effective dose. High relapse rate for urine spraying upon withdrawal.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El alprazolam es una benzodiacepina potente de acción corta a intermedia, utilizada principalmente en medicina veterinaria como ansiolítico y sedante leve. Es una sustancia controlada de Lista IV (C-IV).
Aspectos clínicos destacados:
- Modificación conductual: Se prescribe frecuentemente como terapia adyuvante para trastornos de pánico, fobias a tormentas, ansiedad por separación y eliminación inapropiada (p. ej., marcaje con orina en gatos).
- Función motora: En comparación con el diazepam, el alprazolam puede tener un menor impacto negativo en la función motora a dosis bajas, lo que lo hace favorable para pacientes ambulatorios.
- Perla clínica: Debido a que es altamente liposoluble, tiene un inicio de acción rápido cuando se administra por vía oral, lo que lo hace ideal para ansiedades situacionales (p. ej., tormentas eléctricas, fuegos artificiales) si se administra 30-60 minutos antes del evento desencadenante.
Mecanismo de acción
Alprazolam exerts its effects by binding to specific benzodiazepine receptors located on the GABA-A receptor complex in the central nervous system.
- Mechanism: Binding → enhances the affinity of the receptor for gamma-aminobutyric acid (GABA) → increases the frequency of chloride channel opening → cellular hyperpolarization → decreased neuronal excitability.
- Target Areas: It primarily depresses subcortical levels of the CNS, specifically the limbic system, thalamus, and hypothalamus.
- Net Effect: This enhanced inhibitory neurotransmission produces the characteristic anxiolytic, sedative, skeletal muscle relaxant, and anticonvulsant effects.
Seguridad y advertencias
Contraindicaciones
- Known benzodiazepine hypersensitivity
- Aggressive animals (controversial; anxiety reduction may disinhibit aggressive tendencies)
Efectos adversos
- Sedation
- Increased appetite (polyphagia)
- Transient ataxia
- Behavior changes in cats (irritability, increased affection, depression, aberrant demeanor)
- Paradoxical CNS excitement/agitation (rare in dogs)
- Physical dependence (with chronic use)
- Impeded learning and retarded training
Precauciones
Caution: Use with care in patients with hepatic or renal disease, narrow-angle glaucoma, and in debilitated or geriatric patients.
- Working Animals: Benzodiazepines may impair the abilities of working or service animals.
- Aggression: Use in aggressive dogs remains controversial as it may remove anxiety-based bite inhibition.
- Pregnancy: FDA Category D in humans. May cause congenital abnormalities if administered during the first trimester. Use only when benefits clearly outweigh risks.
- Hepatic Function: Monitor hepatic enzymes, particularly in cats receiving chronic therapy, due to the risk of idiosyncratic hepatotoxicity associated with some oral benzodiazepines.
Interacciones farmacológicas
May slow the rate, but not the extent of oral absorption of alprazolam; administer 2 hours apart.
Additive CNS depression effects may occur.
Serum levels of digoxin may be increased; monitor for toxicity.
Increased alprazolam levels.
Metabolism of alprazolam may be decreased, leading to excessive sedation.
May induce hepatic microsomal enzymes and decrease the pharmacologic effects of benzodiazepines.
Alprazolam may increase levels of these drugs; concurrent use with clomipramine may improve efficacy for phobias.
Inhibits alprazolam metabolism, potentially increasing sedation and toxicity
Inhibits alprazolam metabolism
Used concurrently as an adjunct, but may have additive CNS depressant effects
Monitorización
- Clinical efficacy (reduction in anxiety/panic)
- Adverse effects (excessive sedation, paradoxical excitation)
- Hepatic enzymes (particularly when treating cats chronically)
Farmacocinética
Absorción
Well absorbed orally with an intermediate onset of action. Peak plasma levels occur in 1-2 hours (in humans).
Distribución
Highly lipid soluble and widely distributed throughout the body. Readily crosses the blood-brain barrier. Approximately 80% bound to plasma proteins.
Metabolismo
Metabolized in the liver to at least two metabolites, including alpha-hydroxy-alprazolam which is pharmacologically active.
Eliminación
Elimination half-lives range from 6-27 hours in humans.
Sobredosis
Overdoses are generally limited to CNS signs, primarily dose-dependent CNS depression.
- Clinical Signs: Ataxia, lethargy, disorientation, and vomiting. Some animals may present with a paradoxical reaction (hyperactivity, vocalization, agitation) which may be followed by CNS depression. Severe signs like hypotension, respiratory depression, and cardiac arrest are quite rare in small animals.
- Toxicity: The reported LD50 in rats is >330 mg/kg, but cardiac arrest has occurred at doses as low as 195 mg/kg.
- Treatment: Consists of standard protocols for decontamination. The decision to give activated charcoal should be weighed carefully against the risk of aspiration if the patient is sedated. Flumazenil can be used to reverse the sedative effects, but is generally reserved for cases with significant CNS and respiratory depression.
Productos disponibles
Formulaciones
- Extended-release oral tablets
- Orally disintegrating tablets
- Oral solution
Etiquetado para humanos
- Alprazolam Oral Tablets: 0.25 mg, 0.5 mg, 1 mg & 2 mg (Xanax, generic)
- Alprazolam Extended-release Oral Tablets: 0.5 mg, 1 mg, 2 mg, & 3 mg (Xanax XR, generic)
- Alprazolam Orally Disintegrating Tablets: 0.25 mg, 0.5 mg, 1 mg, & 2 mg (Niravam)
- Alprazolam Oral Solution: 1 mg/mL in 30 mL (Alprazolam Intensol)
Estado regulador
POM (Prescription Only Medicine). Subject to controlled drug regulations depending on member state.
POM. Controlled drug.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store tablets at room temperature in tight, light-resistant containers. Orally disintegrating tablets must be protected from moisture. Compounded oral suspensions (1 mg/mL in Ora-Plus/Ora-Sweet) retain >90% potency for 60 days at 5°C and 25°C, but should be protected from light.
Información para el cliente
- El momento es crucial: Para la ansiedad situacional (como tormentas eléctricas o fuegos artificiales), administre el medicamento aproximadamente 30 a 60 minutos antes del evento previsto para asegurar que haga efecto antes de que la mascota entre en pánico.
- Administración: Si tiene dificultades para administrar pastillas a su mascota, las tabletas de desintegración oral pueden ser una opción. Asegúrese de que sus manos estén completamente secas antes de manipularlas.
- Qué observar: Contacte a su veterinario si nota somnolencia excesiva, inestabilidad grave o cualquier coloración amarillenta en el blanco de los ojos o en las encías (ictericia), especialmente en gatos.
- Cambios de comportamiento: Algunas mascotas pueden volverse inusualmente cariñosas, irritables o incluso más activas (reacción paradójica). Informe a su veterinario si esto ocurre.
- Entrenamiento: Este medicamento puede ralentizar temporalmente la capacidad de su mascota para aprender nuevos comandos durante las sesiones de entrenamiento.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.