Moderate
Alprazolam × Bisoprolol
Benzodiazepines. Short-to-medium-acting anxiolytics×Selective beta-adrenergic blockers
Mechanism
Additive bradycardia and hypotension. Alprazolam sedation may mask early symptoms of excessive blood pressure drop.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk. With additional antihypertensives: bradycardia (pulse below 60/min).
Management
The combination is acceptable for short alprazolam use with pulse and blood pressure monitoring. In older patients, lorazepam at minimum doses is preferable with fall risk warning.