Aprepitant and Alprazolam Interaction
Drug interaction information between Aprepitant and Alprazolam.
Aprepitant and Alprazolam have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Aprepitant and Alprazolam. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Aprepitant slows down how fast your body processes alprazolam, which causes the drug to build up in your blood. This can make you feel much more sleepy or dizzy than usual.
What To Do
Your doctor may need to lower your dose of alprazolam. Watch closely for increased side effects like extreme drowsiness.
FDA Label Information
Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology ( 12.3 )]. Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology ( 12.3 )].
Aprepitant Also Interacts With
- Pimozide major
- Diltiazem moderate
- Methylprednisolone moderate
- Ketoconazole moderate
- Clarithromycin moderate
Alprazolam Also Interacts With
- Ketoconazole moderate
- Clarithromycin moderate
- Itraconazole moderate
- Digoxin moderate
- Fluoxetine moderate
Frequently Asked Questions
Can I take Aprepitant and Alprazolam together?
This is a moderate interaction. Your doctor may need to lower your dose of alprazolam. Watch closely for increased side effects like extreme drowsiness.
How serious is the interaction between Aprepitant and Alprazolam?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Aprepitant and Alprazolam interact?
Aprepitant slows down how fast your body processes alprazolam, which causes the drug to build up in your blood. This can make you feel much more sleepy or dizzy than usual.
Understanding the Aprepitant and Alprazolam Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Aprepitant belongs to the NK1 Receptor Antagonist (Antiemetic) class and Alprazolam belongs to the Benzodiazepine class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Aprepitant slows down how fast your body processes alprazolam, which causes the drug to build up in your blood. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Aprepitant has 22 total documented interactions on file in this dataset, and Alprazolam has 27. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor may need to lower your dose of alprazolam. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Aprepitant or Alprazolam based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.