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Because of increased sensitivity to benzodiazepines in elderly patients, alprazolam at daily doses greater than 2 mg meets the Beers criteria as a medication that is potentially inappropriate for use in older adults. Smaller doses may be effective as well as safer. Total daily doses should rarely exceed suggested maximums. kidney or liver disease (especially alcoholic liver disease); Overview Alprazolam may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Usual Adult Dose for Panic Disorder: asthma or other breathing disorder; a history of drug or alcohol addiction; or Breastfeeding Warnings digoxin; Important information This dose may be gradually increased if needed and tolerated. Extended-release tablets: Do not swallow the orally disintegrating tablet whole. Allow it to dissolve in your mouth without chewing. Do not stop using alprazolam suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using alprazolam. Initial dose: 0.25 mg orally 2 to 3 times a day in elderly or debilitated patients Drinking alcohol with this medicine can cause side effects. The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days if needed and tolerated. Take alprazolam exactly as prescribed by your doctor. Follow all directions on your prescription label. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in treating your symptoms. Alprazolam side effects Call your doctor if this medicine seems to stop working as well in treating your panic or anxiety symptoms. Extended-release tablets: Immediate-release tablets, orally disintegrating tablets: racing thoughts, increased energy, unusual risk-taking behavior; Initial dose: 0.5 to 1 mg once a day Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Maintenance dose: 1 to 10 mg per day in divided doses Initial dose: 0.25 to 0.5 mg orally 3 times a day 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 is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). It affects chemicals in the brain that may be unbalanced in people with anxiety. What happens if I overdose? slurred speech, lack of balance or coordination; Do not use alprazolam if you are pregnant. This medicine can cause birth defects or life-threatening withdrawal symptoms in a newborn. Average Dose: Studies in the treatment of depression have reported an average effective dose of 3 mg orally daily in divided doses This dose may be gradually increased every 3 to 4 days if needed and tolerated. Immediate-release tablets, orally disintegrating tablets, oral concentrate: Mean dose employed: 5 to 6 mg per day in divided doses Usual Adult Dose for Depression: narrow-angle glaucoma; Interactions Usual Geriatric Dose for Anxiety: Where can I get more information? nefazodone; How should I take alprazolam? Alprazolam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine. Initial dose: 0.25 mg orally 2 to 3 times a day in elderly or debilitated patients Alprazolam is used to treat anxiety disorders , panic disorders , and anxiety caused by depression. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. cimetidine; Do not drink alcohol while taking alprazolam. This medication can increase the effects of alcohol. This medicine may be habit-forming and should be used only by the person for whom it was prescribed. Keep the medication in a secure place where others cannot get to it. if you also use a narcotic (opioid) medication. Add to My Med List Do not crush, chew, or break an extended-release tablet . Swallow it whole. Grapefruit and grapefruit juice may interact with alprazolam and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor. This dose may be gradually increased every 3 to 4 days if needed and tolerated. Drug Images This list is not complete. Other drugs may interact with alprazolam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Before taking this medicine if you are also taking itraconazole or ketoconazole; or Usual Geriatric Dose for Panic Disorder: This dose may be gradually increased if needed and tolerated. Call your doctor at once if you have: Maintenance dose: 1 to 10 mg once a day Maintenance dose: May increase up to maximum daily dose of 4 mg in divided doses Immediate-release tablets, orally disintegrating tablets, oral concentrate: Alprazolam may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. User Reviews pounding heartbeats or fluttering in your chest. uncontrolled muscle movements, tremor, seizure (convulsions); or Patient Tips More about alprazolam Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Images Drug Interactions Support Group Pricing & Coupons En Espanol 841 Reviews - Add your own review/rating Consumer resources Alprazolam Alprazolam extended-release tablets Alprazolam orally disintegrating tablets Alprazolam solution Alprazolam Oral (Advanced Reading) Other brands: Xanax , Xanax XR , Alprazolam Intensol , Niravam Professional resources Alprazolam (AHFS Monograph) More (5) » Related treatment guides Anxiety Borderline Personality Disorder Panic Disorder Dysautonomia Depression More (1) » ritonavir or other medicines to treat HIV or AIDS; or antifungal medicine - fluconazole, voriconazole. memory problems; or Alprazolam may also be used for purposes not listed in this medication guide. a history of depression or suicidal thoughts or behavior; 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). It is dangerous to purchase alprazolam on the Internet or from vendors outside the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. The sale and distribution of alprazolam outside the U.S. does not comply with the regulations of the Food and Drug Administration (FDA) for the safe use of this medication. Support Group Q & A feeling anxious early in the morning. Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures. The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days. If you use this medicine long-term, you may need frequent medical tests. Side Effects if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax). Initial dose: 0.5 mg once a day preferably in the morning You should not take alprazolam if you have: Because of increased sensitivity to benzodiazepines in elderly patients, alprazolam at daily doses greater than 2 mg meets the Beers criteria as a medication that is potentially inappropriate for use in older adults. Smaller doses may be effective as well as safer. Total daily doses should rarely exceed suggested maximums. See also: Dosage Information (in more detail) What happens if I miss a dose? Your pharmacist can provide more information about alprazolam. Keep track of the amount of medicine used from each new bottle. Alprazolam is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription. Tell your doctor about all your current medicines and any you start or stop using, especially: The sedative effects of alprazolam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking alprazolam. Maximum Dose: Studies in the treatment of depression have reported to have used 4.5 mg orally daily in divided doses as a maximum. Immediate-release tablets, orally disintegrating tablets, oral concentrate: Pricing & Coupons Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of alprazolam can be fatal. Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, loss of balance or coordination, feeling light-headed, and fainting. fluvoxamine; What should I avoid while taking alprazolam? This dose may be gradually increased if needed and tolerated. open-angle glaucoma; Usual Adult Dose for Anxiety: Usual Geriatric Dose for Depression: Immediate-release tablets, orally disintegrating tablets, oral concentrate: Alprazolam may be habit-forming. Misuse of habit-forming medicine can cause addiction, overdose, or death. Do not use alprazolam if you are pregnant. This medicine can cause birth defects. Your baby could also become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant. Use effective birth control to prevent pregnancy while you are taking this medicine. Common alprazolam side effects may include: Immediate-release tablets, orally disintegrating tablets: Generic Name: alprazolam (al PRAY zoe lam) Brand Names: Niravam, Xanax, Xanax XR Initial dose: 0.25 mg orally 2 to 3 times a day in elderly or debilitated patients confusion, agitation, hostility, hallucinations; Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use alprazolam only for the indication prescribed. Dosage This dose may be gradually increased if needed and tolerated. drowsiness, feeling tired; Store at room temperature away from moisture and heat. depressed mood, thoughts of suicide or hurting yourself; seizures or epilepsy; See also: Side effects (in more detail) Alprazolam dosing information What is alprazolam? Initial dose: 0.5 mg orally 3 times a day Mean dose employed: 3 to 6 mg once a day Initial dose: 0.5 mg orally 3 times a day 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. More Pregnancy Warnings What other drugs will affect alprazolam? Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. 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