BENZODIAZEPINES





Alprazolam (Xanax®)

Dosage forms

Tablet
  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg
Orally disintegrating tablet
  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg
Solution
  • 1 mg/ml
  • Comes in 30 ml bottles

Dosing

Anxiety disorders and transient anxiety
  • Starting: 0.25 - 0.5 mg three times a day as needed. Increase dose every 3 - 4 days as needed.
  • Maximum: 4 mg/day
  • Elderly: starting dose is 0.25 mg two to three times daily as needed. Increase dose gradually.
  • Liver disease: starting dose is 0.25 mg two to three times daily as needed. Increase dose gradually.
  • When discontinuing after chronic therapy, decrease daily dose by no more than 0.5 mg a day every 3 days
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution. May worsen hepatic encephalopathy.

Pharmacokinetics

  • Peak plasma concentration: 1 - 2 hours
  • Half-life: 11.2 hours (range: 6.3 – 26.9 hours)
  • Average half-life is prolonged in elderly (16.3 hours), liver disease (19.7 hours), and obesity (21.8 hours)

Other

  • Alprazolam is a CYP3A4 sensitive substrate. See alprazolam drug interactions for more.
  • Disulfiram (Antabuse®) does not appear to affect the metabolism of alprazolam [10]
  • Asian patients - maximal concentrations and half-life are 15 - 25% higher in Asian patients
  • Cigarette smoking - alprazolam concentrations may be reduced by as much as 50% in smokers compared to nonsmokers

Generic / Price

  • Generic (30 tablets) - $
  • Generic (30 disintegrating tablets) - $-$$
  • Generic (30 ml solution) - $$

Alprazolam (Xanax XR®)

Dosage forms

Tablet, extended-release
  • 0.5 mg
  • 1 mg
  • 2 mg
  • 3 mg

Dosing

Panic disorder
  • Starting: 0.5 - 1 mg once daily. Increase dose every 3 - 4 days in increments of no more than 1 mg/day.
  • Maintenance: 3 - 6 mg once daily
  • Maximum: 10 mg once daily
  • Elderly: starting dose is 0.5 mg once daily. Increase dose gradually as needed.
  • When tapering off, decrease dose by no more than 0.5 mg/day every 3 days
Switching from Xanax to Xanax XR
  • Total daily Xanax dose may be given as once daily Xanax XR tablet
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Clearance is decreased. Use a starting dose of 0.5 mg once daily and titrate gradually.

Pharmacokinetics

  • Xanax XR has the same pharmacokinetics as immediate-release Xanax except that it is absorbed more slowly. The slower absorption rate results in a relatively constant concentration that is maintained between 5 and 11 hours after the dosing.
  • High-fat meals increase the absorption of Xanax XR
  • Peak plasma concentration: 1 - 2 hours
  • Half-life: 11.2 hours (range: 6.3 – 26.9 hours)
  • Average half-life is prolonged in elderly (16.3 hours), liver disease (19.7 hours), and obesity (21.8 hours)

Other

  • Do not cut, chew, crush, or break tablets
  • Alprazolam is a CYP3A4 sensitive substrate. See alprazolam drug interactions for more.
  • Disulfiram (Antabuse®) does not appear to affect the metabolism of alprazolam [10]
  • Asian patients - maximal concentrations and half-life are 15 - 25% higher in Asian patients
  • Cigarette smoking - alprazolam concentrations may be reduced by as much as 50% in smokers compared to nonsmokers

Generic / Price

- YES/$

Chlordiazepoxide (Librium®)

Dosage forms

Capsule
  • 5 mg
  • 10 mg
  • 25 mg

Dosing

Anxiety
  • Mild-to-moderate: 5 - 10 mg three to four times a day as needed
  • Severe: 20 - 25 mg three to four times a day as needed
  • Elderly: 5 mg two to four times a day as needed
Alcohol withdrawal
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution.

Pharmacokinetics

  • Peak plasma concentration: 2 hours
  • Half-life: 24 - 48 hours

Other

  • Disulfiram decreases the clearance of chlordiazepoxide. Consider using another benzodiazepine (e.g. alprazolam, oxazepam, lorazepam) in patients who are receiving disulfiram. [9]

Generic / Price

- YES/$

Chlordiazepoxide + clidinium (Librax®)

Dosage forms

Capsule
  • Chlordiazepoxide : clidinium
    • 5 mg : 2.5 mg

Dosing

Anxiety-related gastrointestinal disorders
  • Dosing: the usual maintenance dose is 1 - 2 capsules three to four times a day as needed, taken before meals and at bedtime
  • Elderly: the initial dose should not exceed 2 capsules per day. Titrate gradually.
  • When discontinuing, the dose should be tapered to prevent withdrawal
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution.

Other

Generic / Price

- YES/$

Chlordiazepoxide + amitriptyline (Limbitrol®)

Dosage forms

Tablet
  • Chlordiazepoxide : amitriptyline
    • 5 mg : 12.5 mg
    • 10 mg : 25 mg

Dosing

Depression associated with anxiety
  • 10/25 mg strength tablets are recommended in an initial dosage of 3 or 4 tablets daily in divided doses; this may be increased to 6 tablets daily as required. Some patients respond to smaller doses and can be maintained on 2 tablets daily.
  • 5/12.5 mg in an initial dosage of 3 or 4 tablets daily in divided doses may be satisfactory in patients who do not tolerate higher doses
  • When discontinuing, the dose should be tapered to prevent withdrawal
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution.

Other

Generic / Price

- YES/$ (30 tablets)

Clobazam | Onfi® | Sympazan®

Dosage forms

Tablet (Onfi®)
  • 10 mg
  • 20 mg
Suspension (Onfi®)
  • 2.5 mg/ml
  • Comes in 120 ml bottle
Oral film (Sympazan®)
  • 5 mg
  • 10 mg
  • 20 mg
  • Film comes in a pouch
  • Comes in packages of 60 pouches

Dosing

Seizures associated with Lennox-Gastaut syndrome (≥ 2 years old)
  • Dosing is based on weight (see table below)
  • Doses > 5 mg/day should be given in divided doses twice daily. A 5 mg daily dose can be administered once daily.
  • Do not proceed with dose escalation more rapidly than weekly, because it takes 5 - 9 days to reach steady-state
  • Taper drug gradually by decreasing the daily dose 5 - 10 mg/day at weekly intervals
  • May take without regard to food
  • Tablets may be halved and crushed
  • Oral film (Sympazan) is applied on top of the tongue where it adheres and dissolves

≤ 66 pounds (30 kg) > 66 pounds (30 kg)
Starting dose 5 mg 10 mg
Starting Day 7 10 mg 20 mg
Starting Day 14 20 mg 40 mg

Elderly
  • Starting dose is 5 mg, and titration should occur at half the recommended dose
CYP2C19 Poor Metabolizers
  • Exposure to active metabolite is increased
  • Starting dose is 5 mg, and titration should occur at half the recommended dose
Liver disease
  • Child-Pugh A/B: starting dose is 5 mg, and titration should occur at half the recommended dose
  • Child-Pugh C: has not been studied. No recommendation given.
Kidney disease
  • CrCl ≥ 30 ml/min: no dose adjustment necessary
  • CrCl < 30 ml/min: has not been studied. No recommendation given.

Pharmacokinetics

  • Peak plasma concentration: 0.5 - 5 hours
  • Half-life:
    • Clobazam: 36 - 42 hours
    • Active metabolite: 71 - 82 hours

Other

  • Clobazam is a sensitive CYP2C19 substrate. See clobazam drug interactions below.
  • Serious skin reactions - serious skin reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), have been reported with clobazam in both children and adults in the postmarketing setting. Patients should be closely monitored for signs or symptoms of SJS/TEN, especially during the first 8 weeks of treatment initiation or when re-introducing therapy. Clobazam should be discontinued at the first sign of rash, unless the rash is clearly not drug-related.
  • Suicidal thoughts and behavior - in trials, antiseizure medications have been associated with a higher risk of suicidal thoughts and behaviors. A pooled analysis of 199 placebo-controlled trials that involved 11 different antiepileptic drugs found that the estimated incidence of suicidal behavior or ideation among 27,863 antiepileptic drug-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients. The increase in risk occurred as early as one week after starting treatment and persisted throughout treatment. The risk was consistent across the drugs analyzed and did not vary by indication (e.g. epilepsy, mood disorders) or age.

Generic / Price

  • Tablet (#60) - YES/$
  • Suspension (120 ml) - YES/$
  • Oral film (#60) - NO/$$$$

Clonazepam (Klonopin®)

Dosage forms

Tablet
  • 0.5 mg
  • 1 mg
  • 2 mg
Orally disintegrating tablet
  • 0.125 mg
  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg

Dosing

Panic disorder (adults)
  • Starting: 0.25 mg twice daily
  • Maintenance: 1 mg/day
  • Maximum: 4 mg/day
  • Increase in increments of 0.125 - 0.25 mg/dose at intervals of 3 days
  • The total daily dose may be given once daily at bedtime to minimize side effects
  • When discontinuing, decrease by 0.125 mg/dose every 3 days
Seizure disorder (adults)
  • Starting: 0.5 mg three times a day
  • Maximum: 20 mg/day
  • Increase in increments of 0.5 - 1 mg/day every 3 days
Seizure disorder (up to 10 years old or 30 kg)
  • Starting: 0.01 - 0.03 mg/kg/day given in 2 or 3 divided doses
  • Maintenance: 0.1 - 0.2 mg/kg/day given in 3 divided doses
  • Maximum: 0.2 mg/kg/day
  • Increase daily dosage by no more than 0.25 - 0.5 mg every third day
Kidney disease
  • Clonazepam metabolites are renally excreted and may accumulate in kidney disease. Use caution.
Liver disease
  • Clonazepam undergoes hepatic metabolism, and liver disease may increase exposure. Use caution.

Pharmacokinetics

  • Peak plasma concentration: 1 - 4 hours
  • Half-life: 30 - 40 hours

Other

  • Start with lower doses and titrate slowly in elderly patients
  • Clonazepam may increase salivation. Use caution in patients at risk for aspiration (e.g. dementia, cognitive impairment).
  • Clonazepam is likely a CYP3A4 sensitive substrate. Use caution with CYP3A4 inducers and inhibitors.

Generic / Price

  • Tablet (#30) - YES/$
  • Orally disintegrating tablet (#30) - YES/$

Clorazepate (Tranxene®)

Dosage forms

Tablet
  • 3.75 mg
  • 7.5 mg
  • 15 mg

Dosing

Anxiety (adults)
  • Starting: 30 mg/day
  • Maintenance: 15 - 60 mg/day
  • Maximum: 60 mg/day
  • May be given 2 - 3 divided doses
  • In elderly or debilitated patients, consider initial daily dose of 7.5 to 15 mg
  • May take without regard to food
Acute alcohol withdrawal (adults)
  • First 24 hours: 30 mg initially; followed by 30 to 60 mg in divided doses
  • Second 24 hours: 45 to 90 mg in divided doses
  • Third 24 hours: 22.5 to 45 mg in divided doses
  • Day 4: 15 to 30 mg in divided doses
  • Day 5 and on: 7.5 - 15 mg/day until ready to discontinue
  • Maximum: 90 mg/day
  • May take without regard to food
Adjunct to Antiepileptic drugs (≥ 12 years)
  • Starting: 7.5 mg three times a day
  • Maximum: 90 mg/day
  • Dosage should be increased by no more than 7.5 mg every week
  • May take without regard to food
Adjunct to Antiepileptic drugs (9 - 11 years)
  • Starting: 7.5 mg two times a day
  • Maximum: 60 mg/day
  • Dosage should be increased by no more than 7.5 mg every week
  • May take without regard to food
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution.

Pharmacokinetics

  • Peak plasma concentration: ?
  • Half-life: 40 - 50 hours

Generic / Price

- YES/$

Diazepam (Valium®)

Dosage forms

Tablet
  • 2 mg
  • 5 mg
  • 10 mg
Solution
  • 1 mg/ml
Concentrate (Intensol)
  • 5 mg/ml

Dosing - Adults

Anxiety disorder (adults)
  • 2 - 10 mg two to four times a day as needed
Alcohol withdrawal
Muscle spasm (adults)
  • 2 - 10 mg three to four times a day as needed
Seizure disorders (adjunctive treatment in adults)
  • 2 - 10 mg two to four times a day as needed
Elderly patients
  • Starting: 2 - 2.5 mg one to two times a day as needed
Children ≥ 6 months old
  • Dosing: 1 - 2.5 mg three to four times a day as needed. Increase gradually as needed and tolerated.
Kidney disease
  • Diazepam metabolites are substantially excreted by the kidneys. Use caution.
Liver disease
  • In patients with cirrhosis, clearance is decreased, and the average half-life is increased 2- to 5-fold. May worsen hepatic encephalopathy. Exercise caution and do not use in severe liver disease.

Pharmacokinetics

  • Peak plasma concentration: 1 - 1.5 hours
  • Half-life:
    • Diazepam - up to 48 hours
    • Active metabolite - up to 100 hours
    • Half-life increases by approximately 1 hour for each year of age beginning with a half-life of 20 hours at 20 years of age

Other

  • Food slows absorption
  • Diazepam is a CYP3A4 and CYP2C19 sensitive substrate. Use caution with CYP3A4 and CYP2C19 inhibitors and inducers.
  • Disulfiram decreases the clearance of diazepam. Consider using another benzodiazepine (e.g. alprazolam, oxazepam, lorazepam) in patients who are receiving disulfiram. [9,11]

Generic / Price

  • Generic (30 tablets) - $
  • Generic (1 mg/ml, 180 ml) - $
  • Generic (5 mg/ml, 30 ml) - $

Diazepam (Diastat® AcuDial)

Dosage forms

Rectal gel
  • Comes in 2.5 mg, 10 mg, and 20 mg delivery system
  • 10 mg delivery system may be dialed to 5, 7.5, and 10 mg doses
  • 20 mg delivery system may be dialed to 12.5, 15, 17.5, and 20 mg doses
  • Comes in pack with 2 delivery systems

Dosing

Acute seizure (≥ 2 years old)
  • 2 - 5 years: 0.5 mg/kg
  • 6 - 11 years: 0.3 mg/kg
  • ≥ 12 years: 0.2 mg/kg
  • Dose should be rounded up to next available dose
  • A second dose may be given 4 - 12 hours after the first dose
  • It takes ∼ 3 minutes for therapeutic concentrations to reach the brain with the rectal route [13]
Kidney disease
  • Diazepam metabolites are substantially excreted by the kidneys. Use caution.
Liver disease
  • In patients with cirrhosis, clearance is decreased and average half-life is increased 2- to 5-fold. May worsen hepatic encephalopathy. Use caution in patients with liver disease.

Pharmacokinetics

  • Peak plasma concentration: 1.5 hours
  • Half-life:
    • Diazepam - 46 hours
    • Active metabolite - 71 hours
  • It takes ∼ 3 minutes for therapeutic concentrations to reach the brain with the rectal route [13]

Other

  • Comes in a single dose rectal delivery system
  • Applicator can be dialed to appropriate dose
  • See patient instructions for proper delivery technique
  • Diazepam is a CYP3A4 and CYP2C19 sensitive substrate. Use caution with CYP3A4 and CYP2C19 inhibitors and inducers.

Generic / Price

- YES/$$$-$$$$ (2 delivery systems)

Diazepam (Valtoco® nasal spray)

Dosage forms

Nasal spray device
  • 5 mg
  • 10 mg
  • 15 mg
  • 20 mg
  • Comes in carton with 2 devices

Dosing

Frequent seizure activity (≥ 6 years)
  • Dosing for Valtoco is based on age and weight and is presented in the table below
  • A second dose, when required, may be administered after at least 4 hours after the initial dose
  • Do not use more than 2 doses to treat a single episode
  • It is recommended that Valtoco be used to treat no more than one episode every five days and no more than five episodes per month

Dose Based on Age and Weight Administration
6 to 11 years
(0.3 mg/kg)		 ≥ 12 years
(0.2 mg/kg)		 Dose (mg) Number of Devices Number of Sprays
10 to 18 kg 14 to 27 kg 5 One 5 mg device One spray in one nostril
19 to 37 kg 28 to 50 kg 10 One 10 mg device One spray in one nostril
38 to 55 kg 51 to 75 kg 15 Two 7.5 mg devices One spray in each nostril
56 to 74 kg ≥ 76 kg 20 Two 10 mg devices One spray in each nostril

Kidney disease
  • Diazepam metabolites are substantially excreted by the kidneys. Use caution.
Liver disease
  • In patients with cirrhosis, clearance is decreased and average half-life is increased 2- to 5-fold. May worsen hepatic encephalopathy. Use caution in patients with liver disease.

Pharmacokinetics

  • Peak plasma concentration: 1.5 hours
  • Half-life (10 mg dose): 49.2 hours

Other

  • Diazepam is a CYP3A4 and CYP2C19 sensitive substrate. Use caution with CYP3A4 and CYP2C19 inhibitors and inducers.

Generic / Price

- NO/$$$$

Flurazepam (Dalmane®)

Dosage forms

Capsule
  • 15 mg
  • 30 mg

Dosing

Insomnia
  • 30 mg one time before bedtime as needed
  • 15 mg may be sufficient in elderly and debilitated patients
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution.

Pharmacokinetics

  • Peak plasma concentration: 30 - 60 minutes
  • Half-life:
    • Flurazepam: 2.3 hours
    • Active metabolite: 47 - 100 hours [3]

Generic / Price

- YES/$

Lorazepam (Ativan®)

Dosage forms

Tablet
  • 0.5 mg
  • 1 mg
  • 2 mg
Solution
  • 2 mg/ml
  • Comes in 30 ml bottle

Dosing

Anxiety
  • Starting: 2 - 3 mg/day given in two to three divided doses
  • Maintenance: 2 - 6 mg/day given in two to three divided doses
  • Elderly: 1 - 2 mg/day given in two to three divided doses
Alcohol withdrawal
Insomnia
  • 2 - 4 mg given once at bedtime
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution. May worsen hepatic encephalopathy.

Pharmacokinetics

  • Peak plasma concentration: 2 hours
  • Half-life: 12 hours
  • Lorazepam is metabolized by glucuronide conjugation

Other

  • See lorazepam drug interactions below
  • Lorazepam is safe in breastfeeding [5]
  • Disulfiram (Antabuse®) does not appear to affect the metabolism of lorazepam [9]

Generic / Price

  • Tablet (#30): YES/$
  • Solution (30 ml): YES/$

Lorazepam (Loreev XR®)

Dosage forms

Capsule, extended-release
  • 1 mg
  • 2 mg
  • 3 mg

Dosing

Anxiety
  • Initiate Loreev XR in patients who are being treated with lorazepam tablets, administered three times daily in evenly divided doses
  • Discontinue lorazepam tablets and administer the first dose of Loreev XR in the morning the day after the final dose of lorazepam tablets
  • The recommended once daily dosage of Loreev XR is equal to the total daily dose of lorazepam tablets. For example, the recommended dosage for patients who have been receiving lorazepam tablets at a dosage of 1 mg three times daily is Loreev XR 3 mg once daily in the morning.
  • Take once daily in the morning with or without food. Swallow capsules whole or open the capsule and sprinkle the entire contents over a tablespoon of applesauce, followed by drinking water. Consume all the sprinkles without chewing within 2 hours; do not store for future use.
  • If dose adjustments are required, discontinue Loreev XR and switch to lorazepam tablets. Once a new dose is established, Loreev XR may be restarted at the new daily dosage.
  • When discontinuing, Loreev XR should be tapered to reduce the risk of withdrawal reactions
  • When combining with UGT inhibitors (e.g. valproate, probenecid), switch to lorazepam tablets so that the lorazepam dose may be reduced. UGT inhibitors increase lorazepam exposure.
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution. May worsen hepatic encephalopathy.

Pharmacokinetics

  • Peak plasma concentration: 14 hours
  • Half-life: 20 hours
  • Lorazepam is metabolized by glucuronide conjugation

Other

  • See lorazepam drug interactions below
  • Lorazepam is safe in breastfeeding [5]
  • Disulfiram (Antabuse®) does not appear to affect the metabolism of lorazepam [9]

Generic / Price

- NO/$$$$

Oxazepam (Serax®)

Dosage forms

Capsule
  • 10 mg
  • 15 mg
  • 30 mg

Dosing

Mild-to-moderate anxiety
  • 10 - 15 mg three to four times a day as needed
Severe anxiety
  • 15 - 30 mg three to four times a day as needed
Alcohol withdrawal
  • 15 - 30 mg three to four times a day as needed
Elderly
  • Starting: 10 mg three times a day as needed
  • Maintenance: 15 mg three to four times a day as needed
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution. May worsen hepatic encephalopathy.

Pharmacokinetics

  • Peak plasma concentration: 3 hours
  • Half-life: 8.2 hours
  • Oxazepam is metabolized by glucuronide conjugation

Other

  • Oxazepam is safe in breastfeeding [6]
  • Oxazepam is the short-acting metabolite of diazepam [6]
  • Disulfiram (Antabuse®) does not appear to affect the metabolism of oxazepam [9]

Generic / Price

- YES/$

Quazepam (Doral®)

Dosage forms

Tablet
  • 15 mg

Dosing

Insomnia
  • Starting: 7.5 mg once at bedtime
  • Maintenance: 7.5 - 15 mg once at bedtime
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Quazepam is extensively metabolized in the liver. It has not been studied in liver disease. Use caution. May worsen hepatic encephalopathy.

Pharmacokinetics

  • Peak plasma concentration: 2 hours
  • Half-life:
    • Quazepam: 39 hours
    • Active metabolite: 73 hours

Other

  • Tablet is scored so that it can be halved

Generic / Price

- NO/$$$$

Temazepam (Restoril®)

Dosage forms

Capsule
  • 7.5 mg
  • 15 mg
  • 22.5 mg
  • 30 mg

Dosing

Insomnia
  • Starting: 15 mg one time at bedtime
  • Maintenance: 7.5 - 30 mg one time at bedtime
  • Elderly: 7.5 mg one time at bedtime
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution. May worsen hepatic encephalopathy.

Pharmacokinetics

  • Peak plasma concentration: 1.5 hours
  • Half-life (biphasic):
    • Short: 0.4 - 0.6 hours
    • Terminal: 8.8 hours

Other

  • Temazepam is a metabolite of diazepam [7]
  • Temazepam appears to be safe in breastfeeding [7]
  • Disulfiram (Antabuse®) may decrease the clearance of temazepam. Consider using another benzodiazepine that has not been shown to interact with disulfiram (alprazolam, oxazepam, lorazepam). [12]

Generic / Price

- YES/$

Triazolam (Halcion®)

Dosage forms

Tablet
  • 0.125 mg
  • 0.25 mg

Dosing

Insomnia
  • Starting: 0.25 mg once daily before bedtime
  • Maintenance: 0.125 - 0.5 mg once daily before bedtime
  • Max: 0.5 mg once daily before bedtime
  • Elderly: start with 0.125 mg once daily. Do not exceed 0.25 mg once daily.
  • A dosage of 0.125 mg once daily may be sufficient for some patients (e.g. patients with low body weight, elderly)
Kidney disease
  • Has not been studied. Use caution.
Liver disease
  • Has not been studied. Use caution. May worsen hepatic encephalopathy.

Pharmacokinetics

  • Peak plasma concentration: within 2 hours
  • Half-life: range of 1.5 - 5.5 hours

Other

  • Triazolam is a CYP3A4 sensitive substrate. It should not be taken with strong CYP3A4 inhibitors, and caution, including possible dose reductions, should be used with weak and moderate inhibitors. Strong CYP3A4 inducers may decrease its exposure and effectiveness.

Generic / Price

- YES/$

















Pricing legend
  • $ = 0 - $50
  • $$ = $51 - $100
  • $$$ = $101 - $150
  • $$$$ = > $150
  • Pricing based on 30 tablets unless otherwise specified
  • Pricing based on information from GoodRX.com®
  • Pricing may vary by region and availability