Major
Established
描述
The combination of alprazolam and oxycodone carries an FDA boxed warning for profound CNS depression, respiratory depression, and death.
机制
Benzodiazepines potentiate GABA-A-mediated CNS inhibition; opioids activate mu-opioid receptors to reduce respiratory drive — additive CNS and respiratory depression occurs.
临床意义
Real-world pharmacoepidemiological studies show a 3.86-fold increase in overdose mortality with concurrent benzodiazepine-opioid prescriptions.
处理措施
Avoid combination when possible; if medically necessary, prescribe the lowest effective doses, limit duration, and provide naloxone.