Moderate
Established
Mô tả
Diphenhydramine adds to the sedative effects of alprazolam, increasing the risk of excessive CNS depression, falls, and cognitive impairment.
Cơ chế
Diphenhydramine's CNS depressant effect (H1 blockade + anticholinergic) is additive to benzodiazepine-mediated GABA-A potentiation.
Ý nghĩa lâm sàng
Particularly dangerous in elderly patients (Beers Criteria lists both drugs as potentially inappropriate); significantly raises fall risk.
Xử trí
Avoid combination in elderly patients; use non-sedating alternatives and consider dose reduction if both are required.