Most severe or fatal overdoses happen when Xanax is taken with other drugs — especially opioid pain medications — or alcohol. If you’re taking Xanax, be sure to tell your doctor about any other medications you’re taking. They may recommend an alternative medication.
Can You Overdose on Xanax?
Xanax is the brand name for alprazolam, a prescription medication used to treat anxiety and panic disorder.
It’s possible to overdose on Xanax, especially if you take Xanax with other drugs or medications. Mixing Xanax with alcohol can also be fatal.
Xanax is in a class of drugs known as benzodiazepines. These drugs work by boosting the activity of a chemical called gamma-aminobutyric acid (GABA) in the brain. GABA helps calm the nerves by inducing feelings of relaxation.
Most severe or fatal overdoses happen when Xanax is taken with other drugs — especially opioid pain medications — or alcohol. If you’re taking Xanax, be sure to tell your doctor about any other medications you’re taking. They may recommend an alternative medication.
The prescribed amount typically ranges from 0.25 to 0.5 milligrams (mg) per day. This amount may be split between three doses throughout the day.
Your doctor may gradually increase your dose until your symptoms are controlled. In some cases, the prescribed amount may be as high at 10 mg per day.
The amount that could potentially lead to an overdose varies widely from person to person. It depends on many factors, including:
- how your body metabolizes the medication
- your weight
- your age
- if you have any preexisting conditions, like a heart, kidney, or liver condition
- if you took it with alcohol or other drugs (including antidepressants)
In clinical studies in rats, the LD50 — the dose that caused half of the rats to die — ranged from 331 to 2,171 mg per kilogram of body weight. This suggests that a person would have to take several thousand times the maximum prescribed dose to fatally overdose.
However, the results of animal studies don’t always translate directly for human specifications. Overdose is possible at any dose higher than your prescribed amount.
People older than 65 have an increased risk for serious side effects, including an overdose. Older adults are typically prescribed lower doses of Xanax because they’re more sensitive to its effects.
Suicide prevention
- If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
- If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Oftentimes, a fatal Xanax overdose is due in part to the use of other drugs or alcohol.
Your body clears Xanax through a pathway known as cytochrome P450 3A (CYP3A). Medications that inhibit CYP3A4 make it harder for your body to break down Xanax, which increases your risk of overdosing.
These medications include:
- antifungal drugs, such as itraconazole and ketoconazole
- sedatives
- opioid pain medications, like fentanyl or oxycodone
- muscle relaxants
- nefazodone (Serzone), an antidepressant medication
- fluvoxamine, a medication for obsessive-compulsive disorder (OCD)
- cimetidine (Tagamet), for heartburn
Drinking alcohol with Xanax also greatly increases your risk of having a lethal overdose.
You should always talk to your doctor about any medications you’re taking. This includes over-the-counter (OTC) medications, vitamins, and other nutritional supplements. This will help your doctor choose the right medication and dosage to reduce your risk of drug interaction.
Overdosing on Xanax or other benzodiazepines can cause mild to severe symptoms. In some cases, death is possible.
Your individual symptoms will depend on:
- how much Xanax you took
- your body chemistry and how sensitive you are to depressants
- whether you took Xanax in conjunction with other drugs
Mild symptoms
In mild cases, you may experience:
- confusion
- uncontrolled muscle movements
- poor coordination
- slurred speech
- tremors
- slow reflexes
- rapid heartbeat
Severe symptoms
In severe cases, you may experience:
- hallucinations
- seizures
- chest pain
- difficulty breathing
- abnormal heart rhythm
- coma
Common Xanax side effects
As with most medications, Xanax can cause mild side effects even at a low dose. The most common side effects include:
These effects are usually mild and will go away in a few days or weeks. If you experience these side effects while taking your prescribed dose, it doesn’t mean you’ve overdosed.
However, you should keep you doctor informed about any side effects you’re experiencing. If they’re more severe, your doctor may want to reduce your dosage or switch you to a different medication.
If you suspect a Xanax overdose has occurred, seek emergency medical care right away. You shouldn’t wait until your symptoms get more severe.
If you’re in the United States, you should contact the National Poison Control Center at 1-800-222-1222 and await further instructions. You can also receive guidance by using their webPOISONCONTROL online tool.
If symptoms become severe, call your local emergency services. Try to stay calm and keep your body cool while you wait for emergency personnel to arrive. You shouldn’t try to make yourself throw up.
If you’re with someone who has overdosed, try to keep them awake and alert until help arrives. Take them to the emergency room or call an ambulance if they’re:
- unconscious
- having a seizure
- having trouble breathing
In the case of an overdose, emergency personnel will transport you to the hospital or emergency room.
They may give you activated charcoal while en route. This can help absorb the medication and potentially alleviate some of your symptoms.
When you arrive at the hospital or emergency room, your doctor may pump your stomach to remove any remaining medication. They may also administer flumazenil, a benzodiazepine antagonist that can help reverse the effects of Xanax.
Intravenous fluids may be necessary to replenish essential nutrients and prevent dehydration.
Once your symptoms have subsided, you may be required to stay in the hospital for observation.
Once the excess medication is out of your system, you’ll most likely make a full recovery.
Xanax should only be taken under medical supervision. You should never take more than your prescribed dose. Talk to your doctor if you think your dose needs to be increased.
Using Xanax without a prescription or mixing Xanax with other drugs can be extremely dangerous. You can never be sure how Xanax will interact with your individual body chemistry or other medications or drugs you’re taking.
If you do choose to misuse Xanax recreationally or mix it with other substances, keep your doctor informed. They can help you understand your individual risk of interaction and overdose, as well as watch for any changes to your overall health.
Last medically reviewed on February 20, 2018
Xanax Overdose: Can You Overdose on Xanax?
By The Recovery Village | Editor Jonathan Strum
Medically Reviewed By Benjamin Caleb Williams, RN A licensed behavioral health or medical professional on The Recovery Village Editorial Team has analyzed and confirmed every statistic, study and medical claim on this page. | Last Updated: May 25, 2022
Using Xanax improperly or mixing the drug with other substances can lead to a potentially deadly overdose. The amount of Xanax it takes to overdose varies.
Article at a Glance:
- Xanax is the brand name for alprazolam, a benzodiazepine drug.
- Because the doses for Xanax can vary widely, the amount of Xanax needed for an overdose can vary as well.
- Mixing Xanax with other central nervous system depressants, such as opioids or alcohol, can increase the risk of overdose.
Xanax, a widely known brand of the drug alprazolam, is one of the most notoriously abused pharmaceuticals in America. As a result of its widespread abuse, Xanax overdose has become a very real problem, with alprazolam ranking consistently in the top 10 drugs contributing to death in the U.S.
This powerful benzodiazepine is prescribed to treat anxiety and panic disorders by lowering abnormal excitement in the brain and producing a more relaxed, calm feeling. Dosages can vary significantly, ranging from 0.25 mg starting doses to 10 mg Xanax “bars” for severe cases. Given this variability, one can most certainly overdose on Xanax if consumed recklessly.
Can You Overdose on Xanax?
It is possible to overdose on Xanax, especially if you take it with another central nervous system (CNS) depressant, such as an opioid. Because Xanax overdoses can be fatal, it is important to be aware of Xanax overdose symptoms and risk factors.
What Happens if You Overdose on Xanax?
Xanax overdose can also occur if you take too much of the drug. Xanax overdose can be deadly, especially when the drug is mixed with other central nervous system (CNS) depressants like opioids or alcohol.
Xanax (alprazolam) is a benzodiazepine. Benzodiazepines alter chemicals in the brain to prevent certain imbalances that cause people to feel nervous or anxious. In the brain, benzodiazepines enhance the effect of a relaxation-inducing chemical called gamma-aminobutyric acid (GABA). Overdosing on Xanax and other CNS depressants increases the effects of GABA to the point of slowing breathing; in some cases, you can stop breathing entirely.
If you find that your Xanax prescription is not relieving symptoms as intended, seek medical advice instead of trying to adjust the dose on your own. Whether you take too high of a Xanax dose or mix the drug with other substances, the risk of overdose death is real.
How Much Xanax Does It Take To Overdose?
The amount of Xanax needed to overdose can vary, especially when the drug is mixed with other substances. Most Xanax overdoses happen when Xanax is taken alongside CNS drugs like alcohol or opioids. Xanax bought on the street can also be counterfeit or cut with the opioid fentanyl, which can increase the risk of overdose.
When combined with the sedative properties of benzos, alcohol and opioids can create a lethal suppression of a person’s breathing or circulatory system. The FDA has a Black Box Warning about mixing benzodiazepines with opioids for this reason.
What Are the Symptoms of a Xanax Overdose?
Whether taking Xanax by itself or with other depressants, it is vital to be able to quickly recognize overdose symptoms in yourself or others. Most of these symptoms are due to Xanax’s CNS depressant effects. Xanax overdose symptoms include:
- Drowsiness, slurred speech and mental status changes, which may occur due to the drug’s sedative nature
- Slowed breathing, which can occur if the drug has been taken with another CNS depressant
- Balance and coordination problems, which may be obvious when performing even simple tasks like walking straight and upright
No overdose symptom should be ignored. If you or someone you know is experiencing any of these symptoms, seek emergency medical assistance immediately.
How Much Xanax Is Too Much?
Different doses of Xanax create different overdose risks for each person. For example, someone who is less tolerant of Xanax may overdose on a lower dose of the drug than someone who has been taking a moderate dose over a longer period of time. Again, combining Xanax with other CNS depressants can increase your overdose risk regardless of the Xanax dose you are taking.
Other FAQs About Xanax Use
How Safe Is Xanax?
Xanax, a prescription drug used for anxiety and panic disorders, is one of the most common medications in the United States. As of 2018, Xanax was the 37th most commonly prescribed medication in the United States, with more than 20 million prescriptions written for it.
Xanax is mostly safe when taken as prescribed, but it can be dangerous when someone combines it with other substances or uses too much. Knowing more information about proper Xanax use — including the dosage and recommended frequency — can help people to understand how much Xanax is too much.
Despite the benefits of using the drug, Xanax can also be extremely addictive. For this reason, benzodiazepines like Xanax are Schedule IV controlled substances. Regularly taking the drug can create a tolerance because the body becomes accustomed to the level of GABA produced. This tolerance means a person would require a larger dose of Xanax to achieve the intended calming effects.
Are There Different Types of Xanax?
Xanax and generic alprazolam come in different dosage forms and doses. These include:
- Oral concentrate: At a concentration of 1 mg of alprazolam for every 1 mL of liquid
- Orally disintegrating tablets: At doses of 0.25 mg, 0.5 mg, 1 mg, 2 mg
- Short-acting tablets: At doses of 0.25 mg, 0.5 mg, 1 mg, 2 mg
- Long-acting tablets: At doses of 0.5 mg, 1 mg, 2 mg, 3 mg
What Are Xanax Bars?
“Xanax bars” is a slang term for Xanax that comes in rectangular tablets. Xanax could come in many different forms; however, 2 mg Xanax tablets manufactured by Pfizer come in a white rectangle form with “XANAX” written on one side and “2” written on the other. These “bars” contain three score marks that allow the pill to be separated into four pieces, enabling it to be used for multiple doses in 0.5 mg increments.
What Is a Normal Dose Amount for Xanax?
Each person’s Xanax dose can vary widely depending on their needs and reasons for taking the drug. As such, it is difficult to generalize a normal dose range. For example, a common starting dose of short-acting Xanax is 0.25 mg when used for anxiety. However, the max dose of short-acting Xanax for anxiety is significantly more than that at 10 mg per day.
Is 1 mg of Xanax a Lot?
A normal starting dose of Xanax is 0.25 mg to 0.5 mg, but it may be up to 1 mg depending on what it is being used for. In unusual cases, people may be increased to doses as high as 10 mg per day, although this is not taken all at once. A dose of 1 mg of Xanax is a higher initial dose, but it may be a normal dose for people who take Xanax regularly.
How Often Can I Take Xanax?
The long-acting dosage form of the drug should be taken once daily, while the shorter-acting dosage forms may be taken more frequently. For example, when used for anxiety, some doctors may prescribe Xanax to be taken up to four times a day.
It is important to note that you should only take Xanax as often as your doctor prescribes it. Taking a higher dose than prescribed or using it more often than prescribed can increase your risk of overdose, physical dependence, tolerance and addiction. If your current dose of Xanax is not helping you, talk to your doctor to explore other alternatives — never adjust the dose on your own.
Xanax Overdose Treatment
Like most substances taken at toxic levels, benzodiazepine overdose treatment mostly depends on a case-by-case basis. Because slowed breathing, low blood pressure and slowed pulse are some of the major risks of Xanax overdose, medical professionals will often address these concerns first. In some cases, doctors may administer flumazenil, a benzodiazepine reversal drug. However, the use of flumazenil is quite uncommon due to the risk of seizures that this medication causes.
Find the Help You or Your Loved One Needs
You can avoid Xanax overdose and recover from your addiction with the help of the right rehabilitation program. The Recovery Village has helped countless men and women take back their lives from substance use disorders. With facilities located across the country, we can help you too. Contact us today to learn more about Xanax addiction treatment programs that can work well for your situation.
Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor’s in Communication in 2017 and has been writing professionally ever since. Read more
Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more
What To Do After You Overdose On Xanax (Alprazolam)
Xanax is a drug commonly prescribed to treat anxiety and panic disorders. Also known as alprazolam, it is a type of benzodiazepine that can have a profound effect on the brain. Although the most common official use is for anxiety, it is sometimes prescribed by doctors for premenstrual disorder, depression and sleeplessness, despite not being approved by the FDA for these uses.
Some people misuse the drug for recreational purposes, often at doses that exceed those a doctor would prescribe, raising the risk of potential overdose. Xanax is relatively quick-acting compared to other drugs, making it attractive to people who want to calm down after a stressful moment, or when they are having trouble sleeping, and can quickly become habit-forming.
After being taken orally, it is absorbed through the GI tract and into the bloodstream quickly and then makes its way into the brain, where it starts to take effect. When too many tablets are taken at once, the body can become overwhelmed.
The Risks Of Xanax
Some research suggests that Xanax is significantly more toxic than other benzodiazepines that are prescribed for anxiety. Its higher prescription rate means that its availability is rising and those with, and without, valid prescriptions are taking it at higher rates, leading to increasing overdoses.
Here are some of the conditions that make a Xanax overdose more likely:
Mixing Xanax With Other Drugs Or Alcohol
Xanax is particularly dangerous when mixed with other types of drugs and/or alcohol. Combining alcohol, opioids and other benzodiazepines can be extremely dangerous as each of these can slow respiration significantly on their own; the effects are multiplied when the drugs/alcohol are combined. When Xanax and alcohol are consumed together, the combined effect of the two sedatives may result in the brain failing to tell the lungs to breathe. If not immediately addressed, the affected person may suffocate.
Building A Tolerance
Another risk factor for Xanax overdose is seen when a person has developed a tolerance to the drug. This means that they need to take more of it to have the same effect previously achieved. People who are taking Xanax under a doctor’s supervision may be switched to a different medication or stop being prescribed Xanax temporarily to avoid having their threshold reach a dangerous level. This is why it is essential to only take the amount that has been prescribed to you.
After stopping Xanax for a period of time, it is essential to take exactly the amount prescribed to you when you begin taking it again rather than the amounts you may have taken in the past as your tolerance levels will have dropped. It is easier to overdose on Xanax when you start taking it again after a period of abstinence, even at levels that were not previously problematic.
Age
Another risk factor for a Xanax overdose is age; the toxicity of this drug is known to become stronger as the body ages. Many doctors are aware of this and prescribe older patients lower doses. However, problems may be seen when a person does not follow their doctor’s recommendations, or builds up tolerance to the lower quantities quickly and starts self-medicating with higher doses.
Signs And Symptoms Of A Xanax Overdose
For many people, some of the earliest signs of a Xanax overdose will resemble the typical side effects of regularly taking the drug. These include:
- Drowsiness
- Headache
- Dry mouth
- Changes in appetite
- Irritability
- Lightheadedness
- Tiredness
- Unusual talkativeness
- Increased salivation
- Difficulty concentrating
- Constipation
- Trouble passing urine
- Joint pain
Some people will experience even more severe side effects. Any of the following should be considered a warning sign of an overdose:
- Breathing trouble
- Hallucinations
- Difficulty speaking
- Depression symptoms, such as a depressed mood or suicidal thoughts
- Confusion
- Memory problems
- Unusual mood or behavior changes
- Yellowing of the skin or eyes
- Loss of balance or coordination
- Memory problems
Call for help right away if you or someone you know experiences any of these serious adverse reaction or overdose symptoms:
- Significantly slowed breathing
- Loss of consciousness
- Profound confusion
- Serious loss of balance
- Severe coordination problems
- Inability to stay awake/severe drowsiness
- Unresponsiveness
Get Help Immediately
If you or someone you know has overdosed on Xanax, or any other drug, call 911 immediately for emergency help. If possible, be prepared to tell the dispatcher how much Xanax the person consumed, along with their age, height and weight.
Stay with the individual who has overdosed and monitor their breathing; if you believe you have overdosed, have someone stay with you until help arrives if possible. Remove anything that the affected person is wearing around their neck, such as a necklace or tie, and ensure that their airway is clear and that they continue to breathe. If they stop breathing, perform mouth-to-mouth resuscitation until help arrives.
Get Medical Treatment For A Xanax Overdose
In an emergency room, a person who has overdosed on Xanax will usually be treated by having their stomach pumped, and will be given intravenous fluids to flush the toxins from their body.
Some people may be given a benzodiazepine antidote known as flumazenil, which may be able to reverse some of the life-threatening effects of an overdose. However, it comes with some health risks of its own, which is why doctors will likely try other interventions first.
Get Treatment For Xanax Addiction
Here are some of the available options for treating addictions to Xanax:
Individual Counseling
This is a type of counseling in which you will meet with a substance abuse counselor to discuss your mental health and recovery on a one-on-one basis as frequently as needed. This type of counseling offers the chance to form a bond with a therapist which may help you to feel comfortable opening up about the issues that may have contributed to your addiction.
Group Therapy
Group therapy sessions managed by self-help groups, 12-step programs and counselors can be helpful for people who thrive in group settings and benefit from the support of others who are in a similar situation to their own. It is often used in conjunction with individual counseling or other types of inpatient or outpatient treatment.
Inpatient Treatment
Inpatient treatment requires a temporary stay at a drug rehabilitation center, which may be 30 days to several months, depending on the severity of your addiction. This allows for intensive therapy and enables you to address the underlying issues that led to your reliance on the drug.
Outpatient Treatment
Outpatient treatment allows you to continue to live at home and even attend school or work while also meeting with a counselor several times a week. There are also full-day options that allow you to get intensive therapy during the day before returning home to your family at night.
Reach Out To Aquila Recovery Clinic
If you have any concerns about your Xanax use, or that of a loved one, or you are ready to change your life after surviving an overdose, contact Aquila Recovery Clinic today. Our team of Washington, D.C. addiction recovery specialists can guide you on your journey through our intensive and regular outpatient programs, family recovery programs and individual therapy to ensure you get the help you need in a way that suits your lifestyle.
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