alprazolam

al-PRA-zoe-lam

Commonly used brand name(s)

In the U.S.

• Gabazolamine-0.5


• Niravam


• Xanax


• Xanax XR

In Canada

• Alti-Alprazolam

Available Dosage Forms:

• Tablet


• Tablet, Disintegrating


• Solution


• Tablet, Extended Release

Therapeutic Class: Antianxiety

Pharmacologic Class: Benzodiazepine, Short or Intermediate Acting

Uses For alprazolam

Alprazolam is used to relieve symptoms of anxiety, including anxiety caused by depression. It is also used to treat panic disorder in some patients.

Alprazolam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

alprazolam is available only with your doctor's prescription.

Before Using alprazolam

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For alprazolam, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to alprazolam or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of alprazolam in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of alprazolam in the elderly. However, severe drowsiness, dizziness, confusion, clumsiness, or unsteadiness are more likely to occur in the elderly, who are usually more sensitive than younger adults to the effects of alprazolam. Elderly patients may require a lower dose to help reduce unwanted effects.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using alprazolam.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking alprazolam, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using alprazolam with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Delavirdine


• Indinavir


• Itraconazole


• Ketoconazole

Using alprazolam with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil


• Amobarbital


• Anileridine


• Aprobarbital


• Boceprevir


• Butabarbital


• Butalbital


• Carisoprodol


• Chloral Hydrate


• Chlorzoxazone


• Codeine


• Dantrolene


• Digoxin


• Ethchlorvynol


• Fentanyl


• Fluconazole


• Fospropofol


• Hydrocodone


• Hydromorphone


• Levorphanol


• Meperidine


• Mephenesin


• Mephobarbital


• Meprobamate


• Metaxalone


• Methocarbamol


• Methohexital


• Morphine


• Morphine Sulfate Liposome


• Oxycodone


• Oxymorphone


• Pentobarbital


• Phenobarbital


• Primidone


• Propoxyphene


• Remifentanil


• Secobarbital


• Sodium Oxybate


• Sufentanil


• Tapentadol


• Thiopental


• Voriconazole


• Zolpidem

Using alprazolam with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Amprenavir


• Aprepitant


• Carbamazepine


• Cimetidine


• Clarithromycin


• Desipramine


• Desogestrel


• Dienogest


• Drospirenone


• Erythromycin


• Estradiol Cypionate


• Estradiol Valerate


• Ethinyl Estradiol


• Ethynodiol Diacetate


• Etonogestrel


• Fluoxetine


• Fosaprepitant


• Imipramine


• Kava


• Levonorgestrel


• Medroxyprogesterone Acetate


• Mestranol


• Nefazodone


• Norelgestromin


• Norethindrone


• Norgestimate


• Norgestrel


• Rifapentine


• Ritonavir


• Roxithromycin


• Sertraline


• St John's Wort


• Telaprevir


• Theophylline


• Troleandomycin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of alprazolam. Make sure you tell your doctor if you have any other medical problems, especially:

• Depression or


• Epilepsy or history of seizures or


• Lung disease—Use with caution. May make these conditions worse.

• Glaucoma, acute narrow angle—Should not be used in patients with this condition.

• Kidney disease or


• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of alprazolam

Take alprazolam only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Swallow the extended-release tablet whole with a full glass of water. Do not break, crush, or chew it.

If you are using the orally disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not remove the tablets from the bottle until you are ready to take it. Place the tablet immediately on the top of your tongue. It should melt quickly and be swallowed with saliva.

If you are using the oral solution, measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup.

Dosing

The dose of alprazolam will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of alprazolam. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For anxiety:
  
  • For oral dosage forms (solution, tablets, or orally disintegrating tablets):
    
    • Adults—At first, 0.25 to 0.5 milligram (mg) three times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 4 mg a day.
    
    
    • Older adults—At first, 0.25 milligram (mg) two or three times a day. Your doctor may increase your dose if needed.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  


• For panic disorder:
  
  • For oral dosage form (extended-release tablets):
    
    • Adults—At first, 0.5 to 1 milligram (mg) taken in the morning once a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 10 mg a day.
    
    
    • Older adults—At first, 0.5 milligram (mg) taken in the morning once a day. Your doctor may increase your dose if needed.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  
  • For oral dosage forms (solution, tablets, or orally disintegrating tablets):
    
    • Adults—At first, 0.5 milligram (mg) three times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 10 mg a day.
    
    
    • Older adults—At first, 0.25 milligram (mg) two or three times a day. Your doctor may increase your dose if needed.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of alprazolam, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

It is very important to protect the orally disintegrating tablets from moisture. Remove and throw away any cotton packaging from the medicine bottle when you first use the medicine.

Precautions While Using alprazolam

It is very important that your doctor check your progress at regular visits to make sure alprazolam is working properly. Blood tests may be needed to check for any unwanted effects.

Using alprazolam while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not take itraconazole (Sporanox®) or ketoconazole (Nizoral®) while you are using alprazolam. Using any of them together with alprazolam may increase the chance of serious side effects.

If you develop any unusual and strange thoughts or behavior while you are taking alprazolam, be sure to discuss it with your doctor. Some changes that have occurred in people taking alprazolam are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

Alprazolam may cause some people, especially older persons, to become drowsy, dizzy or less alert than they are normally. Make sure you know how you react to alprazolam before you drive, use machines, or do anything else that could be dangerous if you are dizzy, or are not alert or able to see well.

Do not stop taking alprazolam without checking with your doctor first. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, such as convulsions (seizures), stomach or muscle cramps, sweating, tremors, vomiting, or unusual behavior.

alprazolam will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates (used for seizures); muscle relaxants; or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop taking alprazolam. Check with your doctor before taking any of the above while you are using alprazolam.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

alprazolam Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Being forgetful


• changes in patterns and rhythms of speech


• clumsiness or unsteadiness


• difficulty with coordination


• discouragement


• drowsiness


• feeling sad or empty


• irritability


• lack of appetite


• lightheadedness


• loss of interest or pleasure


• relaxed and calm


• shakiness and unsteady walk


• sleepiness or unusual drowsiness


• slurred speech


• tiredness


• trouble concentrating


• trouble in speaking


• trouble performing routine tasks


• trouble sleeping


• unsteadiness, trembling, or other problems with muscle control or coordination


• unusual tiredness or weakness

Less common

• Abdominal or stomach pain


• blurred vision


• body aches or pain


• burning, crawling, itching, numbness, prickling, "pins and needles, or tingling feelings


• changes in behavior


• chills


• clay-colored stools


• confusion about identity, place, and time


• cough


• dark urine


• decrease in frequency of urination


• decrease in urine volume


• diarrhea


• difficult or labored breathing


• difficulty in moving


• difficulty in passing urine (dribbling)


• difficulty with concentration


• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly


• dry mouth


• ear congestion


• environment seems unreal


• fainting


• fear or nervousness


• feeling of unreality


• feeling warm


• fever


• general feeling of discomfort or illness


• headache


• hyperventilation


• inability to move eyes


• inability to sit still


• increased blinking or spasms of the eyelid


• irregular heartbeats


• itching


• joint pain


• lack or loss of self-control


• loss of bladder control


• loss of coordination


• loss of memory


• loss of voice


• mood or mental changes


• muscle aching or cramping


• muscle pain or stiffness


• muscle weakness


• nasal congestion


• nausea


• need to keep moving


• painful urination


• problems with memory


• rash


• restlessness


• runny nose


• seeing, hearing, or feeling things that are not there


• seizures


• sense of detachment from self or body


• shaking


• shivering


• shortness of breath


• sneezing


• sore throat


• sticking out of the tongue


• sweating


• swollen joints


• talkativeness


• tightness in the chest


• trouble in breathing, speaking, or swallowing


• trouble with balance


• twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs


• uncontrolled twisting movements of the neck, trunk, arms, or legs


• unpleasant breath odor


• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness


• unusual facial expressions


• unusually deep sleep


• unusually long duration of sleep


• vomiting of blood


• wheezing


• yellow eyes or skin

Rare

• Actions that are out of control


• attack, assault, or force


• chest pain


• continuing ringing or buzzing or other unexplained noise in ears


• decreased awareness or responsiveness


• deep or fast breathing with dizziness


• ear pain


• false or unusual sense of well-being


• fast, irregular, pounding, or racing heartbeat or pulse


• feeling jittery


• feeling unusually cold


• generalized slowing of mental and physical activity


• hearing loss


• hoarseness


• lack of feeling or emotion


• loss of control of the legs


• loss of strength or energy


• nightmares


• numbness of the feet, hands, and around mouth


• severe sleepiness


• shakiness in the legs, arms, hands, or feet


• sleep talking


• sleeplessness


• swelling


• talking, feeling, and acting with excitement


• thoughts of killing oneself


• unable to sleep


• uncaring


• unusual weak feeling


• voice changes

Incidence not known

• General tiredness and weakness


• light-colored stools


• stomach pain, continuing


• upper right abdominal pain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Absent, missed, or irregular menstrual periods


• decreased appetite


• decreased interest in sexual intercourse


• decreased sexual performance or desire abnormal ejaculation


• difficulty having a bowel movement (stool)


• inability to have or keep an erection


• increased appetite


• increased in sexual ability, desire, drive, or performance


• increased interest in sexual intercourse


• increased weight


• loss in sexual ability, desire, drive, or performance


• stopping of menstrual bleeding


• watering of mouth


• weight loss

Less common

• Abdominal bloating and cramping


• blistering, crusting, irritation, itching, or reddening of the skin


• change in taste bad unusual or unpleasant (after) taste


• cracked, dry, or scaly skin


• cramps


• double vision


• feeling of warmth


• heavy bleeding


• menstrual changes


• pain


• pelvic pain


• redness of the face, neck, arms, and occasionally, upper chest


• seeing double


• sudden sweating


• unexplained runny nose or sneezing

Rare

• Acid or sour stomach


• belching


• bigger, dilated, or enlarged pupils (black part of eye)


• change in color vision


• difficulty seeing at night


• feeling of constant movement of self or surroundings


• feeling of relaxation


• heartburn


• hives or welts


• increased sensitivity of eyes to sunlight


• indigestion


• redness of skin


• runny nose


• sensation of spinning


• stomach discomfort, upset, or pain


• stuffy nose

Incidence not known

• Blistering, peeling, or loosening of the skin


• red, irritated eyes


• red skin lesions, often with a purple center


• sores, ulcers, or white spots in the mouth or on the lips


• swelling of the breasts or breast soreness in both females and males


• unexpected or excess milk flow from breasts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: alprazolam side effects (in more detail)

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More alprazolam resources

• Alprazolam Side Effects (in more detail)
• Alprazolam Use in Pregnancy & Breastfeeding
• Drug Images
• Alprazolam Drug Interactions
• Alprazolam Support Group
• 406 Reviews for Alprazolam - Add your own review/rating

• Alprazolam Prescribing Information (FDA)


• Alprazolam Professional Patient Advice (Wolters Kluwer)


• Alprazolam Monograph (AHFS DI)


• Alprazolam MedFacts Consumer Leaflet (Wolters Kluwer)


• Niravam Prescribing Information (FDA)


• Niravam Orally Disintegrating Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Xanax Prescribing Information (FDA)


• Xanax Consumer Overview


• Xanax XR Prescribing Information (FDA)


• Xanax XR Consumer Overview


• Xanax XR Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

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