Uses

What is alprazolam used for?

Alprazolam is commonly used to treat the following conditions.

Alprazolam may also be used for other conditions as determined by your healthcare provider.

How does alprazolam work (mechanism of action)?

Alprazolam  produces a calming effect on the brain, which helps to reduce anxiety and promote relaxation.

How is alprazolam supplied (dosage forms)?

Brands and other names

  • Xanax
  • Xanax XR

Dosage forms and strengths

  • 1 mg/mL oral solution
  • 0.5 mg, 1mg, 2 mg, 3 mg extended-release oral tablets
  • 0.25 mg, 0.5 mg, 1mg, 2 mg oral tablets

How should I store alprazolam?

Oral Tablet. Alprazolam tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Some tablets need to be protected from light. Ask your healthcare provider if you have any questions about how to store your medicine.

Oral Liquid. Alprazolam solution should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from light. Throw away 90 days after opening the bottle. You can write the date on the bottle the day you open it as a reminder.

Side Effects

What are the most common side effects of alprazolam?

The most common side effects of alprazolam are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Trouble with balance or coordination
  • Low blood pressure
  • Trouble saying words clearly (dysarthria)
  • Changes in sex drive
  • Problems with memory
  • Drowsiness
  • Constipation or nausea

There may be other side effects of alprazolam that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of alprazolam?

While less common, the most serious side effects of alprazolam are described below, along with what to do if they happen.

Severe Allergic Reactions. Alprazolam can cause allergic reactions, which can be serious. Stop taking alprazolam and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Risk of Misuse and Addiction. Misusing alprazolam can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take alprazolam exactly as prescribed. Tell your healthcare provider if you feel that alprazolam is not working. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

  • Sudden confusion or feeling disoriented
  • Feeling paranoid
  • Suicidal thoughts or actions
  • Seizures
  • Trouble breathing

Dependence and Withdrawal Reactions. Alprazolam can cause physical dependence, which means your body relies on the medicine to function properly. If you stop alprazolam suddenly, it could lead to withdrawal symptoms, which may be life-threatening. Do not stop taking alprazolam without talking with your healthcare provider. Your healthcare provider will tell you how to stop alprazolam to reduce the risk of withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

  • Unusual movements, responses, or expressions
  • Seizures
  • Sudden and severe mental or nervous system changes
  • Seeing or hearing things that others do not see or hear, also called hallucinations
  • An extreme increase in activity or talking
  • Losing touch with reality

Some people may have the following symptoms of a withdrawal reaction that can last for several weeks to more than 12 months.

  • Anxiety
  • Trouble remembering, learning, or concentrating
  • Depression
  • Problems sleeping
  • Feeling like insects are crawling under the skin
  • Weakness, shaking, or muscle twitching
  • Burning or prickling feeling in the hands, arms, legs, or feet
  • Ringing in the ears

Decreased Alertness or Coordination. Alprazolam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how alprazolam affects you.

Warnings & Precautions

Who should not use alprazolam?

Allergies to Ingredients. People who are allergic to any of the following should not take alprazolam.

  • Xanax
  • Xanax XR
  • Alprazolam
  • Any other medicine known as a benzodiazepine
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all the ingredients in the specific alprazolam products they stock.

Drug Interactions. Alprazolam should not be taken while you are using certain other medicines. Before taking alprazolam, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about alprazolam before using it?

Do not take alprazolam unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share alprazolam with other people, even if they have the same condition as you. It may harm them.

Keep alprazolam out of the reach of children. Alprazolam is a controlled substance because it can be misused or lead to dependence. Store alprazolam in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

Use an accurate measuring device to measure your dose of liquid alprazolam. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

Do not crush, chew, or break alprazolam extended-release tablets. Swallow them whole. 

Alprazolam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how alprazolam affects you.

People who are aged 65 years or older can be at greater risk for some side effects of alprazolam. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using alprazolam?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if alprazolam is right for you.

In particular, make sure that you discuss any of the following.

Depression. Taking alprazolam if you have depression may lead to an extremely elevated mood (mania) or can worsen your depression. You and your family and friends should be on the lookout for signs of worsening depression or risk of suicide. Tell your healthcare provider if you have depression. 

Substance Use Disorder. Alprazolam is a controlled substance and may be misused or lead to dependence. Tell your healthcare provider if you have a history of substance use disorder or alcohol use disorder.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Mood problems
  • Thoughts of suicide or dying or suicide attempts
  • Lung or breathing problems
  • Liver or kidney problems

Pregnancy. It is not known if or how alprazolam could affect pregnancy or harm an unborn baby. Taking alprazolam during the later stages of pregnancy can result in withdrawal and the following symptoms, in newborns.

  • Drowsiness
  • Breathing problems
  • Sluggish
  • Low muscle tone
  • Jittery
  • Fussiness or irritability
  • Restlessness
  • Shaking
  • Excessive crying
  • Feeding problems

Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant during treatment with alprazolam, talk to your healthcare provider about registering with the National Pregnancy Registry for Psychiatric Medications. You can register by calling 866-961-2388 or visiting www.womensmentalhealth.org/pregnancyregistry.

Breastfeeding. Alprazolam passes into breast milk. Breastfeeding a child while taking alprazolam can lead to sleepiness, feeding problems, and decreased weight gain in the child. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take alprazolam while breastfeeding.

Interactions

Does alprazolam interact with foods or drinks?

There are no known interactions between alprazolam and foods or drinks.

Do not drink alcohol while taking alprazolam. The risk of serious problems such as severe dizziness, sleepiness, trouble breathing, coma, and death may be higher if you drink alcohol while taking alprazolam.

Does alprazolam interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. 

In particular, make sure to discuss if you are using any of the following before taking alprazolam.

  • An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of pain
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Ritonavir (Norvir), which is a medicine commonly used to treat HIV
  • Ketoconazole or itraconazole (Sporanox, Tolsura), which is a medicine used for fungal infections
  • Clarithromycin, which is a medicine used for bacterial infections

Many other medicines may alter the blood levels of alprazolam. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with alprazolam. Always check with your healthcare provider.

Does Alprazolam (Xanax) interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much alprazolam?

If you or someone else has taken too much alprazolam, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of alprazolam?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses. 

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