Moderate
Alprazolam × Losartan
Benzodiazepines. Short-to-medium-acting anxiolytics×Angiotensin II receptor blockers (sartans)
Mechanism
Additive hypotension. Alprazolam sedation may mask 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.