Moderate
Alprazolam × Captopril
Benzodiazepines. Short-to-medium-acting anxiolytics×ACE inhibitor
Mechanism
Additive hypotension. Alprazolam sedation may mask early orthostatic symptoms.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
In older patients, check standing and sitting blood pressure 1–2 weeks after start. Alternative anxiolytic: hydroxyzine or a short lorazepam course.