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if you also use a narcotic (opioid) medication.


Do not crush, chew, or break an extended-release tablet . Swallow it whole.
The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days.
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).

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.
Drug Images
fluvoxamine;
nefazodone;
Interactions
feeling anxious early in the morning.

Immediate-release tablets, orally disintegrating tablets, oral concentrate:
You should not take alprazolam if you have:
Breastfeeding Warnings
Immediate-release tablets, orally disintegrating tablets, oral concentrate:
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.
This dose may be gradually increased if needed and tolerated.
What is alprazolam?


a history of drug or alcohol addiction; or
Maintenance dose: May increase up to maximum daily dose of 4 mg in divided doses
drowsiness, feeling tired;
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.

Call your doctor if this medicine seems to stop working as well in treating your panic or anxiety symptoms.

User Reviews
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.
Call your doctor at once if you have:

confusion, agitation, hostility, hallucinations;




Drinking alcohol with this medicine can cause side effects.
To make sure this medicine is safe for you, tell your doctor if you have:
See also: Side effects (in more detail) Alprazolam dosing information
Alprazolam side effects


Store at room temperature away from moisture and heat.

Mean dose employed: 5 to 6 mg per day in divided doses



digoxin;
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.

Initial dose: 0.5 mg orally 3 times a day
Usual Adult Dose for Panic Disorder:
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.


uncontrolled muscle movements, tremor, seizure (convulsions); or
seizures or epilepsy;
If you use this medicine long-term, you may need frequent medical tests.

Do not swallow the orally disintegrating tablet whole. Allow it to dissolve in your mouth without chewing.

Initial dose: 0.5 mg once a day preferably in the morning

Usual Geriatric Dose for Depression:
Side Effects
depressed mood, thoughts of suicide or hurting yourself;

Grapefruit and grapefruit juice may interact with alprazolam and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.


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.
ritonavir or other medicines to treat HIV or AIDS; or
slurred speech, lack of balance or coordination;
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.
See also: Dosage Information (in more detail) What happens if I miss a dose?
Xanax: 12 Things You Should Know
Alprazolam may also be used for purposes not listed in this medication guide.
Add to My Med List

Important information

Support Group Q & A
racing thoughts, increased energy, unusual risk-taking behavior;



Immediate-release tablets, orally disintegrating tablets:
What happens if I overdose?
Initial dose: 0.25 mg orally 2 to 3 times a day in elderly or debilitated patients
Alprazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). It affects chemicals in the brain that may be unbalanced in people with anxiety.


Your pharmacist can provide more information about alprazolam.
Immediate-release tablets, orally disintegrating tablets, oral concentrate:
Misuse of habit-forming medicine can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.

Usual Adult Dose for Depression:

Dosage


kidney or liver disease (especially alcoholic liver disease);


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.
Immediate-release tablets, orally disintegrating tablets:

Do not use alprazolam if you are pregnant. This medicine can cause birth defects or life-threatening withdrawal symptoms in a newborn.
a history of depression or suicidal thoughts or behavior;



Alprazolam may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
This dose may be gradually increased every 3 to 4 days if needed and tolerated.
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.
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.
Common alprazolam side effects may include:


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.
Maintenance dose: 1 to 10 mg once a day

Extended-release tablets:
if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).
Extended-release tablets:


cimetidine;


if you are also taking itraconazole or ketoconazole; or

Slideshow

Pricing & Coupons

Initial dose: 0.25 mg orally 2 to 3 times a day in elderly or debilitated patients
Patient Tips
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.


Initial dose: 0.25 mg orally 2 to 3 times a day in elderly or debilitated patients



More Pregnancy Warnings

asthma or other breathing disorder;
The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days if needed and tolerated.
Alprazolam is not approved for use by anyone younger than 18 years old.

Alprazolam may be habit-forming. Misuse of habit-forming medicine can cause addiction, overdose, or death.
Do not stop using alprazolam suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using alprazolam.

What other drugs will affect alprazolam?



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.


This dose may be gradually increased if needed and tolerated.

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: 0.5 mg orally 3 times a day
How should I take alprazolam?

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.
What should I avoid while taking alprazolam?
Usual Geriatric Dose for Panic Disorder:
open-angle glaucoma;


narrow-angle glaucoma;

Alprazolam is used to treat anxiety disorders , panic disorders , and anxiety caused by depression.

Immediate-release tablets, orally disintegrating tablets, oral concentrate:


Overview

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) »
Usual Adult Dose for Anxiety:
Maintenance dose: 1 to 10 mg per day in divided doses



This dose may be gradually increased if needed and tolerated.
Maximum Dose: Studies in the treatment of depression have reported to have used 4.5 mg orally daily in divided doses as a maximum.


Initial dose: 0.5 to 1 mg once a day



memory problems; or

Usual Geriatric Dose for Anxiety:
Average Dose: Studies in the treatment of depression have reported an average effective dose of 3 mg orally daily in divided doses
Mean dose employed: 3 to 6 mg once a day
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.

Before taking this medicine



pounding heartbeats or fluttering in your chest.


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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.
Tell your doctor about all your current medicines and any you start or stop using, especially:

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.

Professional

Initial dose: 0.25 to 0.5 mg orally 3 times a day



This dose may be gradually increased if needed and tolerated.
This dose may be gradually increased every 3 to 4 days if needed and tolerated.


Generic Name: alprazolam (al PRAY zoe lam) Brand Names: Niravam, Xanax, Xanax XR
Where can I get more information?
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.

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