What is alprazolam?

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Generic Name: Alprazolam Brand Name(s): Generics only. No brands available.

Know the basics

What is alprazolam used for?

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 should I take alprazolam?

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.

This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as seizures) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Report any withdrawal reactions immediately.

Along with its benefits, this medication may rarely cause abnormal drug-seeking behavior (addiction). This risk may be increased if you have abused alcohol or drugs in the past. Take this medication exactly as prescribed to lessen the risk of addiction.

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.

How do I store alprazolam?

Alprazolam is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store alprazolam in the bathroom or the freezer. There may be different brands of alprazolam that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush alprazolam down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using alprazolam?

Before taking alprazolam:

  • Tell your doctor and pharmacist if you are allergic to alprazolam, chlordiazepoxide (Librium, Librax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), estazolam (ProSom), flurazepam (Dalmane), halazepam (Paxipam), lorazepam (Ativan), oxazepam (Serax), prazepam (Centrax), quazepam (Doral), temazepam (Restoril), triazolam (Halcion), or any other medications.
  • Tell your doctor if you are taking itraconazole (Sporanox) or ketoconazole (Nizoral). Your doctor willl probably tell you not to take alprazolam.
  • Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements, you are taking. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); antidepressants (‘mood elevators’) such as desipramine (Norpramin), imipramine (Tofranil), and nefazodone ; antifungals such as fluconazole (Diflucan), posaconazole (Noxafil), or voriconazole (Vfend); antihistamines; cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); diltiazem (Cardizem, Dilacor, Tiazac); ergotamine (Cafatine, Cafergot, Wigraine, others); erythromycin (E.E.S., E-Mycin, Erythrocin); isoniazid (INH, Nydrazid); medications for mental illness, chronic pain, and seizures; nicardipine (Cardene); nifedipine (Adalat, Procardia); oral contraceptives (birth control pills); propoxyphene (Darvon); selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • Tell your doctor and pharmacist what herbal products you are taking, especially St. John’s wort.
  • Tell your doctor if you have glaucoma (increased pressure in the eye that may cause loss of sight). Your doctor may tell you not to take alprazolam.
  • Tell your doctor if you have or have ever had depression; if you have had thoughts of suicide or harming yourself; if you have alcoholism or if you drink or have ever drunk large amounts of alcohol;if you use or have ever used street drugs or have overused prescription medications;if you smoke; if you have had seizures;or if you have or have ever had lung, kidney, or liver disease.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Alprazolam may harm the fetus. If you become pregnant while taking alprazolam, call your doctor .
  • Talk to your doctor about the risks and benefits of taking this medication if you are 65 years of age or older. Older adults should receive low doses of alprazolam because higher doses may not work better and may cause serious side effects.
  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking alprazolam.
  • You should know that alprazolam may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • Talk to your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects of alprazolam worse.

Is it safe to take alprazolam during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown.

Know the side effects

What are the side effects of alprazolam?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • Depressed mood, thoughts of suicide or hurting yourself, unusual risk-taking behavior, decreased inhibitions, no fear of danger;
  • Confusion, hyperactivity, agitation, hostility, hallucinations;
  • Feeling like you might pass out;
  • Urinating less than usual or not at all;
  • Chest pain, pounding heartbeats or fluttering in your chest;
  • Uncontrolled muscle movements, tremor, seizure (convulsions);
  • Jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • Drowsiness, dizziness, feeling tired or irritable;
  • Blurred vision, headache, memory problems, trouble concentrating;
  • Sleep problems (insomnia);
  • Swelling in your hands or feet;
  • Muscle weakness, lack of balance or coordination, slurred speech;
  • Upset stomach, nausea, vomiting, constipation, diarrhea;
  • Increased sweating, dry mouth, stuffy nose;
  • Appetite or weight changes, loss of interest in sex.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with alprazolam?

Alprazolam may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, non-prescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

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.

Before using alprazolam, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, other sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by alprazolam.

Tell your doctor about all other medicines you use, especially:

  • Birth control pills;
  • Cimetidine (tagamet);
  • Cyclosporine (gengraf, neoral, sandimmune);
  • Dexamethasone (cortastat, dexasone, solurex, dexpak);
  • Ergotamine (cafergot, ergomar, migergot);
  • Imatinib (gleevec);
  • Isoniazid (for treating tuberculosis);
  • John’s wort;
  • An antibiotic such as clarithromycin (biaxin), erythromycin (e.e.s., eryped, ery-tab, erythrocin, pediazole), rifabutin (mycobutin), rifampin (rifadin, rifater, rifamate), rifapentine (priftin), or telithromycin (ketek);
  • Antifungal medication such as miconazole (oravig) or voriconazole (vfend);
  • An antidepressant such as fluoxetine (prozac, sarafem, symbyax), fluvoxamine (luvox), desipramine (norpramin), imipramine (janimine, tofranil), or nefazodone;
  • A barbiturate such as butabarbital (butisol), secobarbital (seconal), pentobarbital (nembutal), or phenobarbital (solfoton);
  • Heart or blood pressure medication such as amiodarone (cordarone, pacerone), diltiazem (tiazac, cartia, cardizem), nicardipine (cardene), nifedipine (nifedical, procardia), or quinidine (quin-g);
  • Hiv/aids medicine such as atazanavir (reyataz), delavirdine (rescriptor), efavirenz (sustiva, atripla), etravirine (intelence), indinavir (crixivan), nelfinavir (viracept), nevirapine (viramune), saquinavir (invirase), or ritonavir (norvir, kaletra); or
  • Seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline).

Does food or alcohol interact with alprazolam?

Alprazolam may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug, especially:

  • Grapefruit Juice.

What health conditions may interact with alprazolam?

Alprazolam may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

  • Depression;
  • Epilepsy or history of seizures;
  • 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;
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Understand the dosage

The information provided is not a substitute for medical advice. Always consult your doctor or pharmacist before using this medication.

What is the dose of Alprazolam for an adult?

Usual Adult Dose for Anxiety

Immediate-release tablets, orally disintegrating tablets, oral concentrate:
Initial dose: 0.25 to 0.5 mg orally 3 times a day
This dose may be gradually increased every 3 to 4 days if needed and tolerated.
Maintenance dose: May increase up to maximum daily dose of 4 mg in divided doses

Usual Adult Dose for Panic Disorder

Immediate-release tablets, orally disintegrating tablets:
Initial dose: 0.5 mg orally 3 times a day
This dose may be gradually increased every 3 to 4 days if needed and tolerated.
Maintenance dose: 1 to 10 mg per day in divided doses
Mean dose employed: 5 to 6 mg per day in divided doses
Extended-release tablets:
Initial dose: 0.5 to 1 mg once a day
The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days if needed and tolerated.
Maintenance dose: 1 to 10 mg once a day
Mean dose employed: 3 to 6 mg once a day

Usual Adult Dose for Depression

Immediate-release tablets, orally disintegrating tablets, oral concentrate:
Initial dose: 0.5 mg orally 3 times a day
The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days.
Average Dose: Studies on the use of alprazolam for the treatment of depression have reported an average effective dose of 3 mg orally daily in divided doses
Maximum Dose: Studies on the use of alprazolam for the treatment of depression have reported to have used 4.5 mg orally daily in divided doses as a maximum.

What is the dose of Alprazolam for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is alprazolam available?

Alprazolam is available in the following dosage forms and strengths:

Tablet, Extended Release, Oral: 0.5 mg, 1 mg, 2 mg, 3 mg.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Symptoms of overdose may include:

  • Drowsiness;
  • Confusion;
  • Problems with coordination;
  • Loss of consciousness.

What should I do if I miss a 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 take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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