Moderate
Alprazolam × clonidine
Benzodiazepines. Short-to-medium-acting anxiolytics×Central α2-adrenergic agonist
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.