Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.
Alprazolam – Uses, Side Effects, and More
Alprazolam has a risk for abuse and addiction, which can lead to overdose and death. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems (especially opioid medications such as codeine, hydrocodone) may cause very serious side effects, including death. To lower your risk, your doctor should have you take the smallest dose of alprazolam that works, and take it for the shortest possible time. Be sure you know how to take alprazolam and what other drugs you should avoid taking with it. See also Drug Interactions section. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.
Suddenly stopping this medication may cause serious (possibly fatal) withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as headaches, trouble sleeping, restlessness, hallucinations/confusion, depression, nausea, or seizures. Withdrawal symptoms may sometimes last weeks to months.
Warnings:
Alprazolam has a risk for abuse and addiction, which can lead to overdose and death. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems (especially opioid medications such as codeine, hydrocodone) may cause very serious side effects, including death. To lower your risk, your doctor should have you take the smallest dose of alprazolam that works, and take it for the shortest possible time. Be sure you know how to take alprazolam and what other drugs you should avoid taking with it. See also Drug Interactions section. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.
Suddenly stopping this medication may cause serious (possibly fatal) withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as headaches, trouble sleeping, restlessness, hallucinations/confusion, depression, nausea, or seizures. Withdrawal symptoms may sometimes last weeks to months.
Uses
Alprazolam is used to treat anxiety and panic disorders. It belongs to a class of medications called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body (GABA).
How to use alprazolam oral
See also Warning section.
Read the Medication Guide provided by your pharmacist before you start taking alprazolam and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth as directed by your doctor. Dosage is based on your medical condition, age, and response to treatment. Your dose may be gradually increased until the drug starts working well. Follow your doctor’s instructions closely to reduce the risk of side effects.
Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.
When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.
Tell your doctor if your condition lasts or gets worse.
Side Effects
See also Warning section.
Drowsiness, dizziness, increased saliva production, or change in sex drive/ability may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes (such as hallucinations, thoughts of suicide), trouble speaking, loss of coordination, trouble walking, memory problems.
Get medical help right away if these rare but very serious side effects occur: yellowing eyes or skin, seizures.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking alprazolam, tell your doctor or pharmacist if you are allergic to it; or to other benzodiazepines (such as diazepam, lorazepam); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe lung/breathing problems (such as COPD, sleep apnea), liver disease, kidney disease, personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), glaucoma.
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially loss of coordination and drowsiness. These side effects can increase the risk of falling.
Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using alprazolam. Alprazolam may harm an unborn baby. Newborn babies of mothers who use this medication late in pregnancy may have symptoms such as slow/shallow breathing, nonstop crying, shaking, or trouble feeding. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.
This drug passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
Interactions
See also Warning section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: kava, sodium oxybate.
Other medications can affect the removal of alprazolam from your body, which may affect how alprazolam works. Examples include adagrasib, azole antifungals (such as itraconazole, ketoconazole), cimetidine, certain anti-depressants (such as fluoxetine, fluvoxamine, nefazodone), protease inhibitors (such as indinavir), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), St. John’s wort, drugs used to treat seizures (such as phenytoin), among others.
The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), other drugs for sleep or anxiety (such as diazepam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).
Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking.
Alprazolam
Pronunciation: al-PRAY-zoe-lam
Generic name: alprazolam
Brand names: Xanax, Xanax XR, Niravam
Dosage forms: oral concentrate (1 mg/mL), oral tablet (0.25 mg; 0.5 mg; 1 mg; 2 mg), oral tablet, disintegrating (0.25 mg; 0.5 mg; 1 mg; 2 mg), oral tablet, extended release (0.5 mg; 1 mg; 2 mg; 3 mg)
Drug class: Benzodiazepines
Medically reviewed by Sophia Entringer, PharmD. Last updated on Dec 14, 2021.
What is alprazolam?
Alprazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). It is thought that it works by enhancing the activity of certain neurotransmitters in the brain.
Alprazolam is used to treat anxiety disorders, panic disorders, and anxiety caused by depression.
It is dangerous to purchase alprazolam on the Internet or outside the United States. The sale and distribution of medicines outside the U.S. does not comply with safe-use regulations of the Food and Drug Administration (FDA). These medications may contain dangerous ingredients, or may not be distributed by a licensed pharmacy.
Warnings
MISUSE OF ALPRAZOLAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH and should be used only by the person for whom it was prescribed. Keep the medication in a place where others cannot get to it.
Alprazolam can slow or stop your breathing and fatal side effects can occur if you take this medicine with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing.
Do not stop using this medicine without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer.
Get medical help right away if you stop using alprazolam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.
You should not use alprazolam if you have narrow-angle glaucoma, if you also take itraconazole or ketoconazole, or if you are allergic to alprazolam or similar medicines (Valium, Ativan, Tranxene, and others).
Do not use alprazolam if you are pregnant. This medicine can cause birth defects or life-threatening withdrawal symptoms in a newborn.
Before taking this medicine
You should not take alprazolam if:
- you also take antifungal medicine such as itraconazole or ketoconazole; or
- you have a history of allergic reaction to any benzodiazepine (alprazolam, lorazepam, diazepam, Ativan, Valium, Versed, Klonopin, and others).
To make sure alprazolam is safe for you, tell your doctor if you have ever had:
- breathing problems;
- drug or alcohol addiction;
- depression, mood problems, or suicidal thoughts or behavior; or
- kidney or liver disease.
Tell your doctor if you are pregnant or plan to become pregnant. If you use alprazolam during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.
You should not breastfeed.
If you do breastfeed, tell your doctor if you notice drowsiness or feeding problems in the baby.
Not approved for use by anyone younger than 18 years old.
How should I take alprazolam?
Take alprazolam exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use alprazolam in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of alprazolam.
Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.
Measure liquid medicine with the supplied measuring device (not a kitchen spoon).
Swallow the extended-release tablet whole and do not crush, chew, or break it.
Allow the orally disintegrating tablet to dissolve in your mouth without chewing.
Call your doctor if your symptoms do not improve, or if they get worse.
If you use this medicine long-term, you may need frequent medical tests.
Do not stop using alprazolam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use.
Store at room temperature away from moisture, heat, and light. Keep your medicine in a place where no one can use it improperly.
Throw away any alprazolam liquid not used within 90 days.
Dosing information
Usual Adult Dose for Anxiety:
Immediate-release tablets/orally disintegrating tablets (ODT): 0.25 to 0.5 mg orally administered 3 times a day
-Maximum dose: 4 mg/day
Usual Adult Dose for Panic Disorder:
Immediate-release tablets/ODTs: 0.5 mg orally administered 3 times a day
-Maximum dose: 10 mg/day
Extended-release tablets:
-Initial dose: 0.5 to 1 mg orally once a day
-Maintenance dose: 3 to 6 mg orally per day, preferably in the morning
-Maximum dose: 10 mg/day
Usual Geriatric Dose for Anxiety:
Elderly or debilitated patients:
Immediate-release tablets/ODTs: 0.25 mg orally administered 2 or 3 times a day.
Usual Geriatric Dose for Panic Disorder:
Elderly or debilitated patients:
Immediate-release tablets/ODTs:
-Initial dose: 0.25 mg orally administered 2 or 3 times a day
Extended-release tablets:
-Initial dose: 0.5 mg orally once a day
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of alprazolam can be fatal if you take it with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing.
Overdose symptoms may include severe drowsiness, confusion, slurred speech, muscle weakness, loss of balance or coordination, feeling light-headed, slow heartbeats, weak or shallow breathing, fainting, or coma.
What should I avoid while taking alprazolam?
Avoid drinking alcohol. Dangerous side effects or death could occur.
Avoid driving or hazardous activity until you know how alprazolam will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Alprazolam side effects
Get emergency medical help if you have signs of an allergic reaction to alprazolam: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Alprazolam can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Call your doctor at once if you have:
- weak or shallow breathing;
- a light-headed feeling, like you might pass out;
- a seizure;
- hallucinations, risk-taking behavior;
- increased energy, decreased need for sleep;
- racing thoughts, being agitated or talkative;
- double vision; or
- jaundice (yellowing of the skin or eyes).
Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury.
Common alprazolam side effects may include:
- drowsiness; or
- feeling light-headed.
After you stop using alprazolam, get medical help right away if you have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, suicidal thoughts or actions.
Some withdrawal symptoms may last up to 12 months or longer after stopping this medicine suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect alprazolam?
Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.
Taking alprazolam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Many drugs can interact with alprazolam, and some drugs should not be used at the same time. Tell your doctor about all other medicines you use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.
Popular FAQ
One dose of Xanax can last anywhere from 31 hours to 134.5 hours (5.6 days) in the body, depending on factors related to the individual who took it. However, the calming, relaxing, and sedative effects of Xanax usually wear off within about eight to twelve hours. Continue reading
In the US, Farmapram is called alprazolam (brand name: Xanax). Farmapram appears to be a common name for alprazolam in Mexico and may be manufactured in that country. It can be dangerous to purchase alprazolam on the Internet or outside the U.S. It may be against the law to bring these products into the US from a foreign country. Continue reading
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