https://www.vetsurgeon.org/f/clinical-questions/13432/alprazolam-renal-insufficiency I have a geriatric dog who is currently on Tramadol for OA. At a recent checkup the owners mentioned his phobic response to fireworks this year. The dog was seen in 2007 for isosthenuria and mildly raised urea, long story short kidney biopsy showed glomerulonephritisen-USTelligent Community 10https://www.vetsurgeon.org/thread/77583?ContentTypeID=1Wed, 14 Nov 2012 17:44:19 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:5998b0ad-3f3c-4344-9197-45318b21195eRajat<p>[quote user=&quot;Alice Courtney&quot;]In theory, alprazolam is not ideal in cases with hepatic/renal impairment, but from what I can gather, it seems renal impairment prolongs drug half-life[/quote]</p> <p>&nbsp;</p> <p>In these cases I work on prolonging the dosing intervals of the drug concerns or reducing the dose. As he is likely to get just one dose per evening I would start at the lower end of the dose and titrate up gently if not effective. I think it is extremely unlikely to damage the kidneys, it is just that if renal&nbsp; impairment is present the drug&#39;s half life will be longer.</p> <p>Hope that helps </p> <p>&nbsp;</p> <p>&nbsp;</p><div style="clear:both;"></div>