Formulary Benzodiazepine Anti-Anxiety Agents

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Formulary Benzodiazepine Anti-Anxiety Agents

Alprazolam Shortage Recently, alprazolam has been in limited supply at both retail pharmacies and mail service facilities. Alprazolam is commercially manufactured as 0.25mg, 0.5mg, 1mg, and 2mg strength tablets. Retail pharmacies and mail order facilities may have alprazolam in stock but not necessarily all strengths. In response to the shortage of alprazolam, Xanax® (the branded product) has been temporarily added to the formulary. Xanax® XR, a recently approved sustained-release formulation of alprazolam, is not on the Highmark formulary. Although alprazolam quantities are available in limited supply, there are many other benzodiazepines available to treat anxiety. The following generic products in the table below are included on the Highmark formulary. Please consider these alternatives for patients who have difficulty obtaining Xanax or its generic. Formulary Benzodiazepine Anti-anxiety Agents Brandc Name Generic Name Approximate Dosage Range3 Equivalent (mg/day) Dosea, 1 b, 2 Short - Intermediate-acting benzodiazepines Xanax® alprazolam 0.5 mg 0.75 mg – 4 mg Ativan® lorazepam 1 mg 2 mg- 4 mg Serax® oxazepam 15 mg 30 mg – 120 mg b, 2Long-acting benzodiazepines Valium® diazepam 5 mg 4 mg – 40 mg Librium® chlordiazepoxide 10 mg 15 mg – 100 mg Tranxene® clorazepate 7.5 mg 15 mg – 60 mg a Elderly patients are treated with approximately one-half of dose listed b Based on effective half-life of parent drug and active metabolites c Brand products are non-formulary References 1. DiPiro, JT., et al. Pharmacotherapy: A Pathophysiologic Approach. 4th Edition, 1999; 1187 2. Shader RI, Greenblatt DJ. Use of Benzodiazepines in Anxiety Disorders. N Engl J Med 1993; 328: 1398-1405. 3. Wickersham RM, Novak KK, McCarron SM, et al. (editors) Facts and Comparisons. St. Louis, MO.: Facts and Comparisons Inc., 2003. This information presented above has been compiled from the available medical literature and is intended to serve as a reference. Individual patients’ specific situations, which may preclude the use of this information, should always be considered when selecting drug therapy. .

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