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The majority of the aforementioned extended- release products have a recommended dosing interval of once a day. Tegretol XR is the only product with a twice a day dosing interval.

The recommended dosing interval for Xanax XR is also once a day, although some patients may benefit from twice daily dosing. Based on the once-a-day dosing interval and the need to differentiate the extended release formulation from the immediate release formulation, use of the modifier 'XR' would be appropriate to identify the product Xanax XR.

The search of the Adverse Events Reporting System identified eight cases associated with confusion with the modifier 'XR.' Five cases for Effexor/Effexor XR, two cases for Glucophage/Glucophage XR, and one case with Adderall/Adderall XR. In all eight cases confusion between the overlapping strengths of the immediate release and extended release products contributed to the medication error.

Table One shows the overlapping strengths buy xanax in mexico between the immediate release and the extended release products. In six of the eight AERS cases the pharmacist filled either a new or refill buy xanax in mexico prescription with the incorrect formulation (e.g., Effexor XR 75 mg intended, but filled with Effexor 75 mg). One physician dispensed samples of Effexor XR in lieu of Effexor and the second physician "ordered [Glucophage] the new drug but forgot to mention XR form." In all eight chlorpheniramine hydrocodone cases, overlapping strengths may have contributed to the medication errors. Xanax is available in 0.25 mg, 0.5 mg, 1 mg, and 2 mg strengths while Xanax XR is available in hydrocodone bt ibuprofen 0.5 mg, 1 mg, 2 mg, and 3 mg strengths. Overlapping strengths (i.e., 0.5 mg, 1 mg, and 2 mg) may increase the potential risk of medication errors between the immediate and extended buy xanax in mexico release formulations of Xanax. DMETS is concerned that patients may interchange the Xanax XR formulation with the Xanax immediate release formulation since some of the product strengths overlap. Additionally, pharmacy dispensing errors may occur, especially during the launch period, as a result of the overlapping strengths.

DMETS is also concerned with the potential consequences of a medication error if a prescription for Xanax is filled with Xanax XR and vice versa.

Patients who receive Xanax in lieu of Xanax XR may experience reappearance of their symptoms prematurely because the dosing interval of Xanax's immediate release formulation is more frequent than the once a day dosing interval of Xanax XR. Thus the duration of effect of the once-a-day tablet will be longer than the immediate release tablet. The other scenario is that a patient might receive Xanax XR instead of Xanax (e.g., buy xanax in mexico Xanax 1 mg TED filled with Xanax XR 1 mg TID). The proposed package insert indicates that the bioavailability and buy xanax in mexico pharmacokinetics of alprazolam following both Xanax and Xanax XR administration is the same except for the rate of absorption and the peak plasma concentration.

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