Alprazolam: Uses, Dosage, Side Effects

Pronunciation: al-PRAY-zoe-lam
Generic name: alprazolam
Brand names: Xanax, Xanax XR, Niravam
Dosage forms: oral concentrate (1 mg/mL), oral tablet (0.25 mg; 0.5 mg; 1 mg; 2 mg), oral tablet, disintegrating (0.25 mg; 0.5 mg; 1 mg; 2 mg), oral tablet, extended release (0.5 mg; 1 mg; 2 mg; 3 mg)
Drug class: Benzodiazepines

Medically reviewed by Sophia Entringer, PharmD. Last updated on Dec 14, 2021.

What is alprazolam?

Alprazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). It is thought that it works by enhancing the activity of certain neurotransmitters in the brain.

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

It is dangerous to purchase alprazolam on the Internet or outside the United States. The sale and distribution of medicines outside the U.S. does not comply with safe-use regulations of the Food and Drug Administration (FDA). These medications may contain dangerous ingredients, or may not be distributed by a licensed pharmacy.

Warnings

MISUSE OF ALPRAZOLAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH and should be used only by the person for whom it was prescribed. Keep the medication in a place where others cannot get to it.

Alprazolam can slow or stop your breathing and fatal side effects can occur if you take this medicine with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing.

Do not stop using this medicine without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer.

Get medical help right away if you stop using alprazolam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.

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).

Do not use alprazolam if you are pregnant. This medicine can cause birth defects or life-threatening withdrawal symptoms in a newborn.

Before taking this medicine

You should not take alprazolam if:

• you also take antifungal medicine such as itraconazole or ketoconazole; or

• you have a history of allergic reaction to any benzodiazepine (alprazolam, lorazepam, diazepam, Ativan, Valium, Versed, Klonopin, and others).

To make sure alprazolam is safe for you, tell your doctor if you have ever had:

• breathing problems;

• drug or alcohol addiction;

• depression, mood problems, or suicidal thoughts or behavior; or

• kidney or liver disease.

Tell your doctor if you are pregnant or plan to become pregnant. If you use alprazolam during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

You should not breastfeed.

If you do breastfeed, tell your doctor if you notice drowsiness or feeding problems in the baby.

Not approved for use by anyone younger than 18 years old.

How should I take alprazolam?

Take alprazolam exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use alprazolam in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of alprazolam.

Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Swallow the extended-release tablet whole and do not crush, chew, or break it.

Allow the orally disintegrating tablet to dissolve in your mouth without chewing.

Call your doctor if your symptoms do not improve, or if they get worse.

If you use this medicine long-term, you may need frequent medical tests.

Do not stop using alprazolam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use.

Store at room temperature away from moisture, heat, and light. Keep your medicine in a place where no one can use it improperly.

Throw away any alprazolam liquid not used within 90 days.

Dosing information

Usual Adult Dose for Anxiety:

Immediate-release tablets/orally disintegrating tablets (ODT): 0.25 to 0.5 mg orally administered 3 times a day
-Maximum dose: 4 mg/day

Usual Adult Dose for Panic Disorder:

Immediate-release tablets/ODTs: 0. 5 mg orally administered 3 times a day
-Maximum dose: 10 mg/day

Extended-release tablets:
-Initial dose: 0.5 to 1 mg orally once a day
-Maintenance dose: 3 to 6 mg orally per day, preferably in the morning
-Maximum dose: 10 mg/day

Comments:
-The lowest possible effective dose should be administered and the need for continued treatment reassessed frequently.
-Dosage should be reduced gradually when discontinuing therapy or when decreasing the daily dosage.
-The daily dosage may be decreased by no more than 0.5 mg every 3 days; however, some patients may require an even slower dosage reduction.
-The dose of extended-release tablets may be increased at intervals of 3 to 4 days in increments of no more than 1 mg per day.
-The times of administration should be distributed as evenly as possible throughout the waking hours.

Usual Geriatric Dose for Anxiety:

Elderly or debilitated patients:
Immediate-release tablets/ODTs: 0. 25 mg orally administered 2 or 3 times a day.

Usual Geriatric Dose for Panic Disorder:

Elderly or debilitated patients:
Immediate-release tablets/ODTs:
-Initial dose: 0.25 mg orally administered 2 or 3 times a day

Extended-release tablets:
-Initial dose: 0.5 mg orally once a day

Comments:
-If side effects develop, the dose may be lowered.
-The lowest possible effective dose should be administered and the need for continued treatment reassessed frequently.
-Dosage should be reduced gradually when discontinuing therapy or when decreasing the daily dosage.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of alprazolam can be fatal if you take it with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing.

Overdose symptoms may include severe drowsiness, confusion, slurred speech, muscle weakness, loss of balance or coordination, feeling light-headed, slow heartbeats, weak or shallow breathing, fainting, or coma.

What should I avoid while taking alprazolam?

Avoid drinking alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how alprazolam will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Alprazolam side effects

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 can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Call your doctor at once if you have:

• weak or shallow breathing;

• a light-headed feeling, like you might pass out;

• a seizure;

• hallucinations, risk-taking behavior;

• increased energy, decreased need for sleep;

• racing thoughts, being agitated or talkative;

• double vision; or

• jaundice (yellowing of the skin or eyes).

Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury.

Common alprazolam side effects may include:

After you stop using alprazolam, get medical help right away if you have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, suicidal thoughts or actions.

Some withdrawal symptoms may last up to 12 months or longer after stopping this medicine suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin.

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.

What other drugs will affect alprazolam?

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Taking alprazolam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Many drugs can interact with alprazolam, and some drugs should not be used at the same time. Tell your doctor about all other medicines you use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Popular FAQ

One dose of Xanax can last anywhere from 31 hours to 134.5 hours (5.6 days) in the body, depending on factors related to the individual who took it. However, the calming, relaxing, and sedative effects of Xanax usually wear off within about eight to twelve hours. Continue reading

In the US, Farmapram is called alprazolam (brand name: Xanax). Farmapram appears to be a common name for alprazolam in Mexico and may be manufactured in that country. It can be dangerous to purchase alprazolam on the Internet or outside the U.S. It may be against the law to bring these products into the US from a foreign country. Continue reading

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Other brands

Xanax, Xanax XR, Alprazolam Intensol, Niravam

Professional resources

• Prescribing Information

Related treatment guides

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Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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Alprazolam Pill Images – What does alprazolam look like?

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Alprazolam – instructions for use, doses, side effects, reviews of the drug: tablets, 1 mg

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All forms of release, dosages, registration certificates, drug manufacturers, drug characteristics

Description of the drug Alprazolam (tablets, 0.25 mg) based on the official instructions, approved by the manufacturer in 2020 09

• Active substance
• ATX
• Pharmacological group
• Nosological classification (ICD-10)
• Compound
• Dosage and administration
• Release form
• Manufacturer
• Terms of dispensing from pharmacies
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• Best before date
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Active ingredient

Alprazolam* (Alprazolam*)

ATX

N05BA12 Alprazolam

Pharmacological group

Anxiolytic agent (tranquilizer)
[Anxiolytics]

Nosological classification (ICD-10)

ICD-10 code list

Composition

Tablets 90 024	1 tab.
active ingredient:
alprazolam	0.25/1 mg	excipients: lactose monohydrate (milk sugar) – 91.95/137.4 mg; potato starch – 5/7.5 mg; povidone (low molecular weight medical PVP), plasdon K17 – 1.8 / 2.6 mg; magnesium stearate – 1/1.5 mg

Dosage and Administration

Information for healthcare professionals only.
Are you a healthcare professional?

By mouth 2-3 times a day, with or without food. Doses are selected depending on the severity of the syndrome, the individual sensitivity of the patient and his response to the drug. Begin the use of the drug with minimal doses (0.25–0.5 mg / day), followed by an increase, first in the evening and then in the daytime for several days or weeks. Elderly and debilitated patients are prescribed 0.25 mg 2-3 times a day. A further increase in dose to 0.5–0.75 mg / day is carried out with caution if the drug is well tolerated.

In case of anxiety, anxiety, the initial daily dose is 0.75-1.5 mg and can be increased to 3-4.5 mg / day. In panic disorders and depressive conditions, the daily dose can reach 3-6 mg; the highest daily dose is 10 mg.

The course of treatment with alprazolam – from several days (in acute state of fear) to 3 months. Termination of treatment should be carried out within 2-6 weeks, reducing the daily dose by no more than 500 mcg every 3 days, in order to prevent the development of a withdrawal syndrome (abrupt cessation of therapy may cause an exacerbation of anxiety and fear), sometimes even slower withdrawal may be required.

Presentation

Tablets, 0.25 mg, 1 mg. 10 tab. in blisters made of PVC film and aluminum foil. 5 blister packs in a cardboard box.

Producer

Organika JSC. 654034, Russia, Kemerovo region, Novokuznetsk, sh. Kuznetskoye, 3.

Tel.: (3843) 994-222; fax: (3843) 994-200.

www.organica-nk.ru

Name of the organization accepting claims from consumers: Organica JSC, Russia.

Terms of dispensing from pharmacies

By prescription.

Storage conditions

In a place protected from light, at a temperature not exceeding 30 ° C.
List III. List of psychotropic substances whose circulation in the Russian Federation is restricted and for which the exclusion of certain control measures is allowed in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation.

Keep out of reach of children.

Expiry date

5 years.

Do not use after the expiry date which is stated on the packaging.

Update date: 09/15/2022

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Alprazolam

Alprazolam is a sedative used to treat anxiety/stress/depression, panic attacks and sleep disorders.

Analogues (generics, synonyms)

• Zolomax;
• Xanax;
• Alzolam.

Available by prescription, included in the register of strict reporting .
Active ingredient: Alprazolam

Prescription form 148-1/u-88
Latin prescription:
Rp.: Alprazolami 0.00025
D. t.d.: No. 50 in tab.
S: Take by mouth. 1-3 tablets of
for anxiety/panic attacks.
No more than 5 tablets per day.

Rp.: Alprazolami 0.001
D.t.d.: No. 50 in tab.
S: Take by mouth. 1-2 tablets
for anxiety/panic attacks.
No more than 3 tablets per day.

Form
The agent is produced in tablets with a dosage of 0.25 mg and 1 mg, 50 pieces per pack.

1 tablet of Alprazolam 0.25 contains:
Alprazolam 0.25 mg;
Additional ingredients including milk sugar.

1 tablet of Alprazolam 1.0 contains:
Alprazolam – 1 mg;
Additional ingredients including milk sugar.

Mechanism of action
It is thought to act by binding to stereospecific receptors located in the SCN. It has anxiolytic, hypnotic, muscle relaxant and anticonvulsant properties, and also has specific activity in stress crises.

Therapeutic indications
Neuroses, anxieties and fears of various origins, reactive psychoses, panic attacks.

Directions for use
Orally, swallowed whole, with or without food, with plenty of liquid. The dosage is adjusted by the doctor depending on the disease. The maximum daily dose is 10 mg.

Contraindications
Hypersensitivity to alprazolam, benzodiazepines, myasthenia gravis, insuf. Severe respiratory illness, sleep apnea syndrome, severe I. H., angle-closure glaucoma. Acute poisoning by alcohol or other substances acting on the central nervous system.

Warnings and precautions
History of alcohol or drug addiction. It can cause tolerance, physical and mental dependence, bouts of insomnia and anxiety; cause anterograde amnesia; cause psychic and paradoxical reactions, especially in children and the elderly. It is not recommended as a primary first-line psychotic treatment, nor is it used alone for depression-related anxiety due to the risk of suicide. . Do not use in children (<18 years). Use lower doses in the elderly and patients with chronic respiratory failure due to the associated risk of respiratory depression.

Liver failure

Contraindicated due to associated risk of encephalopathy. Caution with moderate-acting intravenous infusion, reduce dose.

Renal failure
Precaution. Adjust doses to avoid severe sedation.

Interactions

Increases sedation: alcohol.
The depressive effect on the central nervous system is enhanced by: antipsychotic (neuroleptic), hypnotics, anxiolytic sedatives, antidepressants, antiepileptic, anesthetic and sedative antihistamines, liver enzyme inhibitors (cytochrome P450 3A4), narcotic analgesics (increase the sedative effect during euphoria may enhance mental addiction).
Do not administer with: antifungal azoles. Reduce dose with: nefazodone, fluvoxamine, and cimetidine.

Precautions: fluoxetine, dextropropoxyphene, oral contraceptives, diltiazem, macrolides. Adjust dosage or stop taking the drug. C: ritonavir.
Increases plasma concentrations of digoxin, especially in the elderly.

Pregnancy
There are no reliable data on teratogenicity and effects on behavior and postpartum development after treatment with benzodiazepines. Initial studies with other drugs from the benzodiazepine group showed that the effect of these drugs on the uterus may be associated with malformations. Subsequent studies of this group of drugs have not shown clear evidence of their association with any type of defect.
There are insufficient data on the use of alprazolam in pregnant women.
Alprazolam is not recommended during pregnancy unless the expected benefits to the mother outweigh the potential risks to the fetus.
If, for medical reasons, alprazolam is prescribed late in pregnancy or at high doses during labor, the neonate may experience effects such as hypothermia, hypotension, and mild respiratory depression.
Babies born to mothers who took benzodiazepines chronically during the last period of pregnancy may develop physical dependence that can cause postpartum withdrawal symptoms.