Major
Established
Descripción
Alprazolam combined with morphine carries an FDA boxed warning for serious risk of respiratory depression, sedation, coma, and death.
Mecanismo
Alprazolam potentiates GABA-A inhibitory tone; morphine reduces brainstem respiratory drive via mu-opioid receptors — both pathways converge on CNS and respiratory depression.
Relevancia clínica
Large database studies confirm excess mortality with concomitant benzodiazepine and opioid prescriptions.
Manejo clínico
Prescribe concurrent opioids and benzodiazepines only when alternatives are inadequate; coprescribe naloxone.