Pharmacokinetics of alprazolam in elderly patients with multiple diseases

The pharmacokinetics of alprazolam (1 mg p.o.) were investigated (using a new developed HPLC-assay) in 10 multimorbid elderly patients (five female, five male; mean age 72.8 +/-8.2 years, creatinine clearance 63.6 +/- 25.9 ml/min, weight 68.9 +/- 13.9 kg). ,,Second peak" plasma concentrations (correlated with age and creatinine clearance) occurred in eight of ten elderly patients. Mean alprazolam concentrations in elderly patients with decreased renal function (creatinine clearance <50 ml/min) were elevated as compared to elderly patients with normal renal function. Alprazolam peak time was correlated with the creatinine clearance, too. Dose reduction should be considered in the elderly multimorbide patients if creatinine clearance is less than 50 ml/min.