What are the common side effects of Xanax? What are the severe side effects of Xanax? What are the long-term side effects of Xanax?

Common Side Effects of Xanax

Xanax, the brand name for the drug alprazolam, is commonly prescribed to treat anxiety disorders such as panic disorder and generalized anxiety disorder. While Xanax can be an effective treatment, it may also cause a range of side effects, some of which are more common than others. Some of the commonly reported mild side effects of Xanax include:

• Sexual side effects*
• Weight loss or weight gain
• Lightheadedness
• Constipation
• Irritability
• Dry mouth
• Increased or decreased hunger
• Problems with coordination
• Fatigue (lack of energy)

*To learn more about this side effect, see the “Side effects up close” section below.

Severe Side Effects of Xanax

In addition to the mild side effects, Xanax can also cause more serious, or severe, side effects. Some of the severe side effects that have been reported with Xanax include:

• Seizures*
• Low blood pressure*
• Extreme drowsiness
• Problems with memory, learning, or concentration
• Not being able to control the muscles used for speech, leading to slowed or slurred speech
• Allergic reaction

*Xanax has a boxed warning for these side effects, which appears on the drug’s label and alerts users to possible serious risks. To learn more, see the “Side effects up close” section below.

Long-Term Side Effects of Xanax

Xanax also carries the risk of long-term side effects, particularly with extended or misuse of the medication. Some of the potential long-term side effects of Xanax include:

• Misuse and addiction
• Dependence and withdrawal

Xanax has boxed warnings for these long-term risks, which are important for users to be aware of. For more details on these warnings, see the “Side effects up close” section below.

Side Effects Up Close

Sexual Side Effects

Xanax has been known to cause sexual side effects in some users. These may include decreased libido, erectile dysfunction, and difficulty achieving orgasm. If you experience any of these sexual side effects while taking Xanax, be sure to discuss them with your healthcare provider.

Seizures and Low Blood Pressure

Xanax carries a boxed warning for the risk of seizures and low blood pressure, particularly if the medication is stopped suddenly or used in combination with opioids. These side effects can be life-threatening, so it’s crucial to follow your healthcare provider’s instructions carefully when taking Xanax.

Misuse, Addiction, Dependence, and Withdrawal

Xanax also has boxed warnings for the risks of misuse, addiction, dependence, and withdrawal. These long-term side effects can be serious and may require medical intervention to manage. It’s important to use Xanax only as prescribed and to never stop taking it abruptly without first consulting your healthcare provider.

Xanax Side Effects in Older Adults

Older adults may be at a higher risk of experiencing side effects from Xanax due to changes in their body’s ability to metabolize the medication. Older adults with kidney or liver problems may be especially susceptible to side effects. For this reason, healthcare providers often start older adults on a lower dosage of Xanax and monitor them closely for any adverse reactions.

Anger as a Xanax Side Effect

Yes, in some cases, anger can be a side effect of Xanax. This is likely due to the medication’s impact on the brain’s neurotransmitters, which can affect mood and behavior. If you experience increased irritability or anger while taking Xanax, be sure to discuss this with your healthcare provider, as they may need to adjust your dosage or consider alternative treatment options.

Conclusion

Xanax can be an effective treatment for anxiety disorders, but it is important to be aware of the potential side effects, both mild and severe, as well as the long-term risks associated with the medication. By understanding the possible side effects and working closely with your healthcare provider, you can make informed decisions about your treatment and manage any adverse reactions that may occur.

Xanax Side Effects: Find Ways To Manage Them

If you have anxiety, your medical professional might recommend that you take a prescription drug called Xanax.

Xanax is used to treat the following types of anxiety in adults:

• panic disorder with or without agoraphobia
• generalized anxiety disorder

The active drug in Xanax is alprazolam.

Xanax comes as a tablet that you take by mouth. It’s typically used as a short-term treatment. If you’d like to learn more about Xanax, including specifics about its uses, you can see this overview of the medication.

As with other drugs, taking Xanax may cause side effects that can be mild or serious. For more information, we encourage you to keep reading.

While taking Xanax, mild or serious side effects may occur. (Side effects are sometimes referred to as adverse effects.)

Here are some examples of side effects commonly reported with Xanax treatment:

• problems with coordination
• not being able to control the muscles you use to speak, which may lead to slowed or slurred speech
• extreme drowsiness
• sexual side effects*
• low blood pressure*

These aren’t all of the side effects that may happen with Xanax. We discuss other possible mild and serious side effects in the sections below.

* To learn more about this side effect, you can see “Side effects up close” below.

You may have mild side effects after taking Xanax.

Examples of mild side effects that have been reported with Xanax include:

• sexual side effects*
• weight loss or weight gain
• lightheadedness
• constipation
• irritability
• dry mouth
• increased or decreased hunger
• problems with coordination
• fatigue (lack of energy)

* To learn more about this side effect, you can see “Side effects up close” below.

Mild side effects of Xanax can last a short or long time. Some may be easily managed, as well. But if you have any symptoms that continue or bother you, we encourage you to talk with your medical professional or pharmacist. Also, it’s important that you don’t stop taking Xanax unless your medical professional recommends it.

It’s possible that Xanax can cause mild side effects other than the ones listed above. We suggest that you refer to the Xanax medication guide for more information.

Note: After the Food and Drug Administration (FDA) approves a medication, it tracks side effects of the drug. If you’d like to notify the FDA about a side effect you’ve had with Xanax, you can visit MedWatch.

Xanax may cause serious side effects. Some serious side effects are more common than others.

Serious side effects that have been reported with Xanax include:

• seizures*
• low blood pressure*
• extreme drowsiness
• problems with memory, learning, or concentration
• not being able to control the muscles you use to speak, which may lead to slowed or slurred speech
• allergic reaction*
• boxed warnings:
  • risk of serious injury or death if used with opioids†
  • risk of misuse and addiction†
  • risk of dependence and withdrawal†

If you develop serious side effects while taking Xanax, it’s important to call your medical professional immediately. If you feel that the side effects are life threatening or if you think you’re having a medical emergency, it’s vital to call 911 or your local emergency number right away.

* To learn more about this side effect, you can see “Side effects up close” below.
† Xanax has a boxed warning for this side effect. The warning appears on the drug’s label and alerts you to possible serious risks. To learn more, you can see the “Side effects up close” section above.

Most of the side effects from Xanax will go away with time. But it’s possible that you may have some long-term side effects of the drug.

For example, Xanax has risks for long-term problems, such as:

• misuse and addiction
• dependence and withdrawal

In fact, Xanax has boxed warnings for these risks. Boxed warnings appear on the drug’s label and alert you to possible serious risks.

For details about these warnings, we encourage you to see the “Side effects up close” section below.

Here are answers to some frequently asked questions about the side effects of Xanax.

What side effects could Xanax cause in older adults?

The side effects of Xanax in older adults are generally expected to be the same as those in younger people. (For details, you can see the “Which side effects of Xanax are mild?” and “Which side effects of Xanax are serious?” sections above.)

However, older adults may have certain health conditions that affect how their bodies respond to Xanax. These include kidney and liver problems. And these conditions could increase the risk of side effects from the drug.

Because of this, it’s recommended that older people are given a low dosage of Xanax to start.

If you’re an older adult, we encourage you to talk with your medical professional. They can advise you about the risks and benefits of taking Xanax to treat your condition.

Is anger a side effect of Xanax?

Yes, in some cases, you may have anger as a side effect of Xanax.

Mood and behavior changes have been reported in studies of Xanax. These changes can include:

• agitation
• irritability
• rage
• aggressive behavior

Your risk for mood and behavior changes with Xanax may be higher if you have:

• certain mental health conditions, such as borderline personality disorder or post-traumatic stress disorder (PTSD)
• a history of aggressive behavior
• alcohol use disorder or another type of substance use disorder

If you’re concerned about your risk for anger as a side effect of Xanax, we suggest that you talk with your medical professional.

How long do side effects of Xanax withdrawal last?

Withdrawal symptoms with Xanax can occur within hours of stopping use of the drug. They might last for several weeks. In rare cases, withdrawal symptoms from Xanax may last for several months.

Xanax has a boxed warning for the risk of withdrawal. Boxed warnings appear on the drug’s label and alert you to possible serious risks. For details about this warning, you can see the “Side effects up close” section below.

If you have more questions about withdrawal and Xanax, we recommend that you talk with your medical professional.

Is it possible to quit taking Xanax without side effects?

With the help of your medical professional, it may be possible to quit taking Xanax without having side effects.

But if you suddenly stop taking Xanax, you may have withdrawal symptoms. It’s important that you don’t stop taking Xanax until your medical professional says it’s safe to do so. When they tell you it’s safe, they’ll lower your dosage slowly over time. This should lessen your risk for withdrawal from the drug.

Xanax has a boxed warning for the risk of withdrawal. Boxed warnings appear on the drug’s label and alert you to possible serious risks. For details about this warning, you can see the “Side effects up close” section below.

If you’d like to learn more about how to stop taking Xanax, it’s important to talk with your medical professional.

Here’s some additional information about some of the side effects that Xanax may cause.

Sexual side effects

Sexual side effects may occur with Xanax use. These side effects were common in studies of the drug.

Xanax may cause changes in your libido (sex drive), which may be higher or lower than usual.

Erectile dysfunction wasn’t specifically reported in the clinical trials of Xanax. But sexual dysfunction was, and this likely includes reports of erectile dysfunction.

It’s important to note that anxiety, which Xanax is used to treat, can also cause sexual side effects. It may be difficult for you to tell if these side effects are caused by the anxiety or by Xanax itself.

Ways to help manage

We recommend that you tell your medical professional about any sexual side effects you have with Xanax. They can help determine if the side effects are from Xanax or the condition the drug is treating.

Seizures

Suddenly stopping Xanax treatment may cause seizures. In some cases, they may be life-threatening. But this side effect was rare in studies of Xanax.

Seizures can cause symptoms such as:

• confusion
• stiffening of your body
• losing control of your bladder or bowels
• spastic movements of your arms and legs
• trouble breathing

Ways to help manage

If you have seizures while taking Xanax, it’s important to tell your medical professional right away. They’ll typically prescribe a different treatment for you.

Low blood pressure

Low blood pressure may occur while taking Xanax. This was a common side effect in studies of the drug.

You may not have any symptoms of low blood pressure unless it’s very low. Possible symptoms of very low blood pressure can include:

• clammy skin
• dizziness
• blurry vision
• lightheadedness
• loss of consciousness

Ways to help manage

If you have any symptoms of low blood pressure while taking Xanax, we recommend that you talk with your medical professional. They may suggest that you check your blood pressure from time to time using a home monitor.

Boxed warnings

Xanax has boxed warnings from the Food and Drug Administration (FDA). Boxed warnings appear on the drug’s label and alert you to possible serious risks.

Risk of serious injury or death if used with opioids. The use of Xanax with opioid drugs may cause severe side effects. These include respiratory depression (weak or slow breathing) and extreme sleepiness. Other possible severe side effects include coma and, in certain cases, death.

Examples of opioids include:

• morphine (Kadian, MS Contin)
• oxycodone (Oxycontin, Roxicodone)
• hydrocodone (Hysingla ER, Zohydro ER)

Risk of misuse and addiction. Xanax treatment may lead to misuse and addiction. Misuse refers to taking a drug in a way other than how your medical professional instructs you to take it. Addiction means continuing to take a drug even if it causes you harmful outcomes. Misuse and addiction can lead to overdose and, in rare cases, death.

Misuse and addiction may cause side effects, such as:

• blurry vision
• feelings of confusion, aggression, or irritability
• tremors
• trouble remembering or concentrating
• trouble speaking or slurred speech
• dizziness
• anxiety

Risk of dependence and withdrawal. You may develop physical dependence with Xanax. This happens when your body gets used to a drug and needs the drug in order to feel as you usually do.

If you suddenly stop taking Xanax and are dependent on it, you may have withdrawal symptoms. In some cases, this may be life threatening.

Withdrawal symptoms from Xanax can include:

• seizures
• restlessness
• muscle stiffness or pain
• anxiety
• problems with digestion, such as loss of appetite, diarrhea, nausea, or vomiting
• dizziness
• hallucinations (hearing or seeing things that aren’t really there)
• headache

Ways to help manage

Below are a few tips for managing the effects of Xanax’s boxed warnings.

Risk with opioids. Before you start taking Xanax, it’s important to tell your medical professional about all the medications you take. If they say that it’s safe to take an opioid with Xanax, they’ll discuss the risks with you. They may also lower your Xanax dosage to lessen your risk for side effects as much as possible.

It’s also advised that while you take Xanax, you talk with them before using any new medications.

Misuse and addiction. It’s recommended that you talk with your medical professional about your risk for misuse and addiction with Xanax. They’ll check you for signs of these conditions before you start taking the drug. They’ll also assess your risk from time to time during your treatment.

Dependence and withdrawal. If you’re concerned about your risk for dependence with Xanax, we encourage you to talk with your medical professional.

We also recommend that you talk with them before you stop taking Xanax. If they tell you it’s safe to stop taking the drug, they’ll lower your dosage slowly over time. This helps reduce your risk for withdrawal symptoms.

It’s important to tell your medical professional right away if you have symptoms of withdrawal from Xanax. They’ll watch your condition closely to help prevent your symptoms from becoming worse. They may also suggest certain treatments to help lessen your withdrawal symptoms.

Suicide prevention

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

• Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
• Text “HOME” to the Crisis Text Line at 741741.
• The Trevor Project provides crisis support for LGBTQIA+ individuals. Call their hotline at 866-488-7386 or text “START” to 678-678.
• Contact the teen-to-teen peer hotline, Teen Line, at 800-852-8336 or text TEEN to 839863.

Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.

Allergic reaction

As with most drugs, Xanax can cause an allergic reaction in some people.

Symptoms of an allergic reaction can be mild or serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you develop mild symptoms of an allergic reaction, such as itchiness, we recommend that you call your medical professional right away. (If a mild reaction isn’t treated, it could become serious.) They may suggest an over-the-counter product to help ease your symptoms.

If they confirm that you had a mild allergic reaction to Xanax, they can advise you about whether it’s safe for you to keep taking the drug.

If you have symptoms of a severe allergic reaction, such as trouble breathing or swelling, it’s vital to call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your medical professional confirms you had a serious allergic reaction to Xanax, they may recommend that you switch to a different treatment.

Monitoring side effects

While you take Xanax, you may want to write down information about any side effects you develop. You can share these notes with your medical professional. This is very helpful to do when you first take new medications or use multiple treatments.

In your notes, you can include answers to questions such as:

• What dosage was I taking when I developed the side effect?
• How long after starting that dosage did I have the side effect?
• What symptoms did I develop?
• How did the side effect impact my everyday activities?
• What other medications was I also taking?
• What other information do I think is important to share?

By writing down notes and sharing them with your medical professional, they’ll learn how Xanax affects you. They can use this information to adjust your treatment plan as needed.

Certain conditions can affect whether it’s safe for you to take Xanax. We describe these factors in more detail below.

FDA boxed warnings

Xanax has boxed warnings from the Food and Drug Administration (FDA) about the following:

• risk of serious injury or death if used with opioids
• risk of misuse and addiction
• risk of dependence and withdrawal

Boxed warnings appear on the drug’s label and alert you to possible serious risks.

For details, you can see the “Side effects up close” section above.

Other warnings

Xanax may not be right for you if you have certain medical conditions or other factors that affect your health. It’s important to talk with your medical professional about your health history before you take Xanax. The list below includes factors to consider.

Lung conditions. Before starting Xanax treatment, it’s recommended that you tell your medical professional if you have any lung conditions. In some situations, death has been reported in people who had severe lung conditions and took Xanax. If you have a lung condition, your medical professional will help determine if it’s safe for you to take the drug.

Depression. If you have depression, taking Xanax may worsen the condition or cause hypomania or mania. Before you start Xanax treatment, let your medical professional know if you have depression. They may prescribe a lower dosage of Xanax than usual.

Liver conditions. Before starting Xanax treatment, be sure your medical professional knows about any liver conditions you have. They may prescribe you a lower dosage of Xanax than usual.

Allergic reaction. If you’ve had an allergic reaction to Xanax or any of its ingredients, it’s advised that you do not take Xanax. You can ask your medical professional what other medications are better options for you.

Alcohol use and Xanax

It’s not safe to drink alcohol while taking Xanax.

Both alcohol and Xanax can lead to central nervous system (CNS) depression. This condition slows your brain activity.

In addition, both CNS depression and Xanax may cause side effects such as drowsiness and loss of coordination. If you drink alcohol while taking Xanax, your risk for these side effects is even higher.

If you drink alcohol, your medical professional can advise you on how to stop drinking while taking Xanax. Or instead, they may prescribe a treatment other than Xanax.

Pregnancy and breastfeeding while taking Xanax

Here’s some information about Xanax, pregnancy, and breastfeeding.

Pregnancy. It may not be safe take Xanax while you’re pregnant. The drug may cause sleepiness and trouble breathing in newborns who were exposed to the drug during pregnancy.

If you do take Xanax during pregnancy, you may want to enroll in a pregnancy registry. These registries collect details about the effects of a drug when used during pregnancy.

You can enroll in the National Pregnancy Registry for Psychiatric Medications by visiting the registry’s site. You can also call 866-961-2388.

To learn more about the registry and whether Xanax is right for you while pregnant, we encourage you to talk with your medical professional.

Breastfeeding. It’s not safe to take Xanax while breastfeeding. The drug can pass into breast milk, which can cause sleepiness in a child who is breastfed.

If you’re breastfeeding or thinking about it, it’s recommended that you talk with your medical professional. They can review your treatment options and healthy ways to feed your child.

Misuse of Xanax is possible. Because of this, Xanax has a boxed warning for misuse and addiction. A boxed warning appears on the drug’s label and alerts you to possible serious risks.

Misuse refers to taking a drug in a way other than how your medical professional told you to take it.

We discuss the risks of misusing Xanax in more detail in the see “Side effects up close” section above.

If you have questions about misuse and Xanax, we encourage you to talk with your medical professional.

Most side effects of Xanax are mild and lessen with time. But in rare cases, serious side effects can happen. If you have questions about possible side effects of Xanax, we suggest that you talk with your medical professional or pharmacist.

Below are a few questions you may find helpful:

• Does my age put me at a higher risk for certain side effects of Xanax?
• Are there any side effects of Xanax that I should tell you about right away?
• Am I at a high risk for misuse and addiction* with Xanax?
• Do I have any health conditions that may increase my risk for side effects of Xanax?

* Xanax has a boxed warning for this side effect. The warning appears on the drug’s label and alerts you to possible serious risks. To learn more, you can see the “Side effects up close” section above.

While you take Xanax, you may find it helpful to speak with a therapist or join a support group. You may also be interested in ways to afford therapy. The following articles might be helpful to you:

• finding a therapist
• online support group information
• affording therapy

You can also visit the BetterHelp website to search for online counseling.

In addition, you can sign up for the Psych Central newsletter. We share stories from other people on mental health journeys, as well as current information about treatments.

Q:

Are there any side effects of Xanax that my body won’t get used to?

Anonymous patient

A:

This will vary from person to person. Some side effects could go away within several weeks and others could remain throughout your treatment. For example, you may have problems with memory, learning, or concentration while taking Xanax. And it’s possible these side effects won’t go away with time.

Side effects can also change if your dosage of Xanax is adjusted, which is common.

In addition, it’s possible to develop a tolerance to Xanax. This means that if you take the medication for an extended period, one dose of Xanax may work less well than usual.

If you have any side effects while taking Xanax, we encourage you to talk with your doctor. They may change your dosage or adjust your treatment plan in another way.

Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Disclaimer: Psych Central has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Xanax Side Effects: Find Ways To Manage Them

If you have anxiety, your medical professional might recommend that you take a prescription drug called Xanax.

Xanax is used to treat the following types of anxiety in adults:

• panic disorder with or without agoraphobia
• generalized anxiety disorder

The active drug in Xanax is alprazolam.

Xanax comes as a tablet that you take by mouth. It’s typically used as a short-term treatment. If you’d like to learn more about Xanax, including specifics about its uses, you can see this overview of the medication.

As with other drugs, taking Xanax may cause side effects that can be mild or serious. For more information, we encourage you to keep reading.

While taking Xanax, mild or serious side effects may occur. (Side effects are sometimes referred to as adverse effects.)

Here are some examples of side effects commonly reported with Xanax treatment:

• problems with coordination
• not being able to control the muscles you use to speak, which may lead to slowed or slurred speech
• extreme drowsiness
• sexual side effects*
• low blood pressure*

These aren’t all of the side effects that may happen with Xanax. We discuss other possible mild and serious side effects in the sections below.

* To learn more about this side effect, you can see “Side effects up close” below.

You may have mild side effects after taking Xanax.

Examples of mild side effects that have been reported with Xanax include:

• sexual side effects*
• weight loss or weight gain
• lightheadedness
• constipation
• irritability
• dry mouth
• increased or decreased hunger
• problems with coordination
• fatigue (lack of energy)

* To learn more about this side effect, you can see “Side effects up close” below.

Mild side effects of Xanax can last a short or long time. Some may be easily managed, as well. But if you have any symptoms that continue or bother you, we encourage you to talk with your medical professional or pharmacist. Also, it’s important that you don’t stop taking Xanax unless your medical professional recommends it.

It’s possible that Xanax can cause mild side effects other than the ones listed above. We suggest that you refer to the Xanax medication guide for more information.

Note: After the Food and Drug Administration (FDA) approves a medication, it tracks side effects of the drug. If you’d like to notify the FDA about a side effect you’ve had with Xanax, you can visit MedWatch.

Xanax may cause serious side effects. Some serious side effects are more common than others.

Serious side effects that have been reported with Xanax include:

• seizures*
• low blood pressure*
• extreme drowsiness
• problems with memory, learning, or concentration
• not being able to control the muscles you use to speak, which may lead to slowed or slurred speech
• allergic reaction*
• boxed warnings:
  • risk of serious injury or death if used with opioids†
  • risk of misuse and addiction†
  • risk of dependence and withdrawal†

If you develop serious side effects while taking Xanax, it’s important to call your medical professional immediately. If you feel that the side effects are life threatening or if you think you’re having a medical emergency, it’s vital to call 911 or your local emergency number right away.

* To learn more about this side effect, you can see “Side effects up close” below.
† Xanax has a boxed warning for this side effect. The warning appears on the drug’s label and alerts you to possible serious risks. To learn more, you can see the “Side effects up close” section above.

Most of the side effects from Xanax will go away with time. But it’s possible that you may have some long-term side effects of the drug.

For example, Xanax has risks for long-term problems, such as:

• misuse and addiction
• dependence and withdrawal

In fact, Xanax has boxed warnings for these risks. Boxed warnings appear on the drug’s label and alert you to possible serious risks.

For details about these warnings, we encourage you to see the “Side effects up close” section below.

Here are answers to some frequently asked questions about the side effects of Xanax.

What side effects could Xanax cause in older adults?

The side effects of Xanax in older adults are generally expected to be the same as those in younger people. (For details, you can see the “Which side effects of Xanax are mild?” and “Which side effects of Xanax are serious?” sections above.)

However, older adults may have certain health conditions that affect how their bodies respond to Xanax. These include kidney and liver problems. And these conditions could increase the risk of side effects from the drug.

Because of this, it’s recommended that older people are given a low dosage of Xanax to start.

If you’re an older adult, we encourage you to talk with your medical professional. They can advise you about the risks and benefits of taking Xanax to treat your condition.

Is anger a side effect of Xanax?

Yes, in some cases, you may have anger as a side effect of Xanax.

Mood and behavior changes have been reported in studies of Xanax. These changes can include:

• agitation
• irritability
• rage
• aggressive behavior

Your risk for mood and behavior changes with Xanax may be higher if you have:

• certain mental health conditions, such as borderline personality disorder or post-traumatic stress disorder (PTSD)
• a history of aggressive behavior
• alcohol use disorder or another type of substance use disorder

If you’re concerned about your risk for anger as a side effect of Xanax, we suggest that you talk with your medical professional.

How long do side effects of Xanax withdrawal last?

Withdrawal symptoms with Xanax can occur within hours of stopping use of the drug. They might last for several weeks. In rare cases, withdrawal symptoms from Xanax may last for several months.

Xanax has a boxed warning for the risk of withdrawal. Boxed warnings appear on the drug’s label and alert you to possible serious risks. For details about this warning, you can see the “Side effects up close” section below.

If you have more questions about withdrawal and Xanax, we recommend that you talk with your medical professional.

Is it possible to quit taking Xanax without side effects?

With the help of your medical professional, it may be possible to quit taking Xanax without having side effects.

But if you suddenly stop taking Xanax, you may have withdrawal symptoms. It’s important that you don’t stop taking Xanax until your medical professional says it’s safe to do so. When they tell you it’s safe, they’ll lower your dosage slowly over time. This should lessen your risk for withdrawal from the drug.

Xanax has a boxed warning for the risk of withdrawal. Boxed warnings appear on the drug’s label and alert you to possible serious risks. For details about this warning, you can see the “Side effects up close” section below.

If you’d like to learn more about how to stop taking Xanax, it’s important to talk with your medical professional.

Here’s some additional information about some of the side effects that Xanax may cause.

Sexual side effects

Sexual side effects may occur with Xanax use. These side effects were common in studies of the drug.

Xanax may cause changes in your libido (sex drive), which may be higher or lower than usual.

Erectile dysfunction wasn’t specifically reported in the clinical trials of Xanax. But sexual dysfunction was, and this likely includes reports of erectile dysfunction.

It’s important to note that anxiety, which Xanax is used to treat, can also cause sexual side effects. It may be difficult for you to tell if these side effects are caused by the anxiety or by Xanax itself.

Ways to help manage

We recommend that you tell your medical professional about any sexual side effects you have with Xanax. They can help determine if the side effects are from Xanax or the condition the drug is treating.

Seizures

Suddenly stopping Xanax treatment may cause seizures. In some cases, they may be life-threatening. But this side effect was rare in studies of Xanax.

Seizures can cause symptoms such as:

• confusion
• stiffening of your body
• losing control of your bladder or bowels
• spastic movements of your arms and legs
• trouble breathing

Ways to help manage

If you have seizures while taking Xanax, it’s important to tell your medical professional right away. They’ll typically prescribe a different treatment for you.

Low blood pressure

Low blood pressure may occur while taking Xanax. This was a common side effect in studies of the drug.

You may not have any symptoms of low blood pressure unless it’s very low. Possible symptoms of very low blood pressure can include:

• clammy skin
• dizziness
• blurry vision
• lightheadedness
• loss of consciousness

Ways to help manage

If you have any symptoms of low blood pressure while taking Xanax, we recommend that you talk with your medical professional. They may suggest that you check your blood pressure from time to time using a home monitor.

Boxed warnings

Xanax has boxed warnings from the Food and Drug Administration (FDA). Boxed warnings appear on the drug’s label and alert you to possible serious risks.

Risk of serious injury or death if used with opioids. The use of Xanax with opioid drugs may cause severe side effects. These include respiratory depression (weak or slow breathing) and extreme sleepiness. Other possible severe side effects include coma and, in certain cases, death.

Examples of opioids include:

• morphine (Kadian, MS Contin)
• oxycodone (Oxycontin, Roxicodone)
• hydrocodone (Hysingla ER, Zohydro ER)

Risk of misuse and addiction. Xanax treatment may lead to misuse and addiction. Misuse refers to taking a drug in a way other than how your medical professional instructs you to take it. Addiction means continuing to take a drug even if it causes you harmful outcomes. Misuse and addiction can lead to overdose and, in rare cases, death.

Misuse and addiction may cause side effects, such as:

• blurry vision
• feelings of confusion, aggression, or irritability
• tremors
• trouble remembering or concentrating
• trouble speaking or slurred speech
• dizziness
• anxiety

Risk of dependence and withdrawal. You may develop physical dependence with Xanax. This happens when your body gets used to a drug and needs the drug in order to feel as you usually do.

If you suddenly stop taking Xanax and are dependent on it, you may have withdrawal symptoms. In some cases, this may be life threatening.

Withdrawal symptoms from Xanax can include:

• seizures
• restlessness
• muscle stiffness or pain
• anxiety
• problems with digestion, such as loss of appetite, diarrhea, nausea, or vomiting
• dizziness
• hallucinations (hearing or seeing things that aren’t really there)
• headache

Ways to help manage

Below are a few tips for managing the effects of Xanax’s boxed warnings.

Risk with opioids. Before you start taking Xanax, it’s important to tell your medical professional about all the medications you take. If they say that it’s safe to take an opioid with Xanax, they’ll discuss the risks with you. They may also lower your Xanax dosage to lessen your risk for side effects as much as possible.

It’s also advised that while you take Xanax, you talk with them before using any new medications.

Misuse and addiction. It’s recommended that you talk with your medical professional about your risk for misuse and addiction with Xanax. They’ll check you for signs of these conditions before you start taking the drug. They’ll also assess your risk from time to time during your treatment.

Dependence and withdrawal. If you’re concerned about your risk for dependence with Xanax, we encourage you to talk with your medical professional.

We also recommend that you talk with them before you stop taking Xanax. If they tell you it’s safe to stop taking the drug, they’ll lower your dosage slowly over time. This helps reduce your risk for withdrawal symptoms.

It’s important to tell your medical professional right away if you have symptoms of withdrawal from Xanax. They’ll watch your condition closely to help prevent your symptoms from becoming worse. They may also suggest certain treatments to help lessen your withdrawal symptoms.

Suicide prevention

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

• Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
• Text “HOME” to the Crisis Text Line at 741741.
• The Trevor Project provides crisis support for LGBTQIA+ individuals. Call their hotline at 866-488-7386 or text “START” to 678-678.
• Contact the teen-to-teen peer hotline, Teen Line, at 800-852-8336 or text TEEN to 839863.

Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.

Allergic reaction

As with most drugs, Xanax can cause an allergic reaction in some people.

Symptoms of an allergic reaction can be mild or serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you develop mild symptoms of an allergic reaction, such as itchiness, we recommend that you call your medical professional right away. (If a mild reaction isn’t treated, it could become serious.) They may suggest an over-the-counter product to help ease your symptoms.

If they confirm that you had a mild allergic reaction to Xanax, they can advise you about whether it’s safe for you to keep taking the drug.

If you have symptoms of a severe allergic reaction, such as trouble breathing or swelling, it’s vital to call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your medical professional confirms you had a serious allergic reaction to Xanax, they may recommend that you switch to a different treatment.

Monitoring side effects

While you take Xanax, you may want to write down information about any side effects you develop. You can share these notes with your medical professional. This is very helpful to do when you first take new medications or use multiple treatments.

In your notes, you can include answers to questions such as:

• What dosage was I taking when I developed the side effect?
• How long after starting that dosage did I have the side effect?
• What symptoms did I develop?
• How did the side effect impact my everyday activities?
• What other medications was I also taking?
• What other information do I think is important to share?

By writing down notes and sharing them with your medical professional, they’ll learn how Xanax affects you. They can use this information to adjust your treatment plan as needed.

Certain conditions can affect whether it’s safe for you to take Xanax. We describe these factors in more detail below.

FDA boxed warnings

Xanax has boxed warnings from the Food and Drug Administration (FDA) about the following:

• risk of serious injury or death if used with opioids
• risk of misuse and addiction
• risk of dependence and withdrawal

Boxed warnings appear on the drug’s label and alert you to possible serious risks.

For details, you can see the “Side effects up close” section above.

Other warnings

Xanax may not be right for you if you have certain medical conditions or other factors that affect your health. It’s important to talk with your medical professional about your health history before you take Xanax. The list below includes factors to consider.

Lung conditions. Before starting Xanax treatment, it’s recommended that you tell your medical professional if you have any lung conditions. In some situations, death has been reported in people who had severe lung conditions and took Xanax. If you have a lung condition, your medical professional will help determine if it’s safe for you to take the drug.

Depression. If you have depression, taking Xanax may worsen the condition or cause hypomania or mania. Before you start Xanax treatment, let your medical professional know if you have depression. They may prescribe a lower dosage of Xanax than usual.

Liver conditions. Before starting Xanax treatment, be sure your medical professional knows about any liver conditions you have. They may prescribe you a lower dosage of Xanax than usual.

Allergic reaction. If you’ve had an allergic reaction to Xanax or any of its ingredients, it’s advised that you do not take Xanax. You can ask your medical professional what other medications are better options for you.

Alcohol use and Xanax

It’s not safe to drink alcohol while taking Xanax.

Both alcohol and Xanax can lead to central nervous system (CNS) depression. This condition slows your brain activity.

In addition, both CNS depression and Xanax may cause side effects such as drowsiness and loss of coordination. If you drink alcohol while taking Xanax, your risk for these side effects is even higher.

If you drink alcohol, your medical professional can advise you on how to stop drinking while taking Xanax. Or instead, they may prescribe a treatment other than Xanax.

Pregnancy and breastfeeding while taking Xanax

Here’s some information about Xanax, pregnancy, and breastfeeding.

Pregnancy. It may not be safe take Xanax while you’re pregnant. The drug may cause sleepiness and trouble breathing in newborns who were exposed to the drug during pregnancy.

If you do take Xanax during pregnancy, you may want to enroll in a pregnancy registry. These registries collect details about the effects of a drug when used during pregnancy.

You can enroll in the National Pregnancy Registry for Psychiatric Medications by visiting the registry’s site. You can also call 866-961-2388.

To learn more about the registry and whether Xanax is right for you while pregnant, we encourage you to talk with your medical professional.

Breastfeeding. It’s not safe to take Xanax while breastfeeding. The drug can pass into breast milk, which can cause sleepiness in a child who is breastfed.

If you’re breastfeeding or thinking about it, it’s recommended that you talk with your medical professional. They can review your treatment options and healthy ways to feed your child.

Misuse of Xanax is possible. Because of this, Xanax has a boxed warning for misuse and addiction. A boxed warning appears on the drug’s label and alerts you to possible serious risks.

Misuse refers to taking a drug in a way other than how your medical professional told you to take it.

We discuss the risks of misusing Xanax in more detail in the see “Side effects up close” section above.

If you have questions about misuse and Xanax, we encourage you to talk with your medical professional.

Most side effects of Xanax are mild and lessen with time. But in rare cases, serious side effects can happen. If you have questions about possible side effects of Xanax, we suggest that you talk with your medical professional or pharmacist.

Below are a few questions you may find helpful:

• Does my age put me at a higher risk for certain side effects of Xanax?
• Are there any side effects of Xanax that I should tell you about right away?
• Am I at a high risk for misuse and addiction* with Xanax?
• Do I have any health conditions that may increase my risk for side effects of Xanax?

* Xanax has a boxed warning for this side effect. The warning appears on the drug’s label and alerts you to possible serious risks. To learn more, you can see the “Side effects up close” section above.

While you take Xanax, you may find it helpful to speak with a therapist or join a support group. You may also be interested in ways to afford therapy. The following articles might be helpful to you:

• finding a therapist
• online support group information
• affording therapy

You can also visit the BetterHelp website to search for online counseling.

In addition, you can sign up for the Psych Central newsletter. We share stories from other people on mental health journeys, as well as current information about treatments.

Q:

Are there any side effects of Xanax that my body won’t get used to?

Anonymous patient

A:

This will vary from person to person. Some side effects could go away within several weeks and others could remain throughout your treatment. For example, you may have problems with memory, learning, or concentration while taking Xanax. And it’s possible these side effects won’t go away with time.

Side effects can also change if your dosage of Xanax is adjusted, which is common.

In addition, it’s possible to develop a tolerance to Xanax. This means that if you take the medication for an extended period, one dose of Xanax may work less well than usual.

If you have any side effects while taking Xanax, we encourage you to talk with your doctor. They may change your dosage or adjust your treatment plan in another way.

Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Disclaimer: Psych Central has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

What is Xanax? Is Xanax a drug? Contact your doctor!

How Xanax works

Alprazolam, an active ingredient in the benzodiazepine group, has a depressant effect on the central nervous system. The drug reduces emotional stress, relieves anxiety, worry and fear. At the same time, the medicine has a hypnotic effect – it shortens the time to fall asleep, increases the duration of sleep, and reduces the number of nocturnal awakenings.

With an increase in the dosage of Xanax, leads to drug intoxication. With regular use, it is addictive and addictive, even if taken strictly according to the doctor’s instructions. Despite the fact that drugs are prescribed by a doctor and are sold only by prescription, more and more people are dependent on them. The distribution and over-the-counter sale of this drug is punishable by law, however, this stops few people.

Alprazolam and its analogues may be prescribed if the person is concerned about:

• alarm conditions;
• sleep disorders;
• neuroses;
• panic attacks;
• anxiety-depressive states, neurotic depressions.

Xanax can also be prescribed in the complex treatment of somatic diseases, drug addiction and alcoholism.

The tranquilizer begins to act very quickly – the person’s mood immediately improves, he feels physical and mental relaxation.

Antidepressant is available in tablets, the dosage is prescribed by the doctor. In case of non-compliance with the rules of admission and regular use of the remedy for depression, a person develops dependence.

Drug addicts experience mild euphoria, peace, self-confidence, physical comfort, calmness after taking Xanax. In some cases, the feeling of fear disappears, which can manifest itself in driving without rules, the absence of fear of heights.

How side effects manifest themselves

When used properly, Xanax effectively relieves anxiety and panic attacks. But the drug is not suitable for everyone and can cause side effects. Also, a side effect can be observed if the dosage is violated.

The drug slows down the reaction, causes drowsiness. But, when the dosage is exceeded, the tranquilizer causes euphoria . A severe overdose can cause fear, aggression, suicidal thoughts.

The drug in large doses affects not only the psyche, it can also cause intestinal disorders, deterioration of the liver, menstrual cycle disorders in women, rashes, itching.

The drug is prescribed only if there are no contraindications.

How Xanax addiction develops

Xanax addiction is not limited to those who use it as a drug. Addiction is also formed in those who drink pills strictly according to the instructions. Prolonged use of a tranquilizer causes withdrawal symptoms. By reducing the dose of pills or stopping them, a person feels a number of extremely unpleasant symptoms. Without a tranquilizer, the addict cannot fully exist – he feels depressed, irritable, tense. Physical manifestations in the form of insomnia, dizziness, sweating, and a general deterioration in well-being are added to psychological discomfort.

If Xanax is prescribed by a physician and the patient adheres to the dosage, addiction develops slowly. Gradually, the drug loses its therapeutic effect, so either a large dosage or a replacement of the drug is required. The specialist controls these moments and selects a safe treatment regimen.

If a tranquilizer is used to achieve drug intoxication, addiction is formed in 2-3 months.

To achieve a euphoric effect, the drug is taken:

• overdose, several tablets at a time;
• combined with alcohol and other drugs.

Stages of drug addiction

The process of addiction formation is usually divided into stages.

• Stage I: mental dependence. Xanax is great for anxiety disorders, neuroses, and depression. But in order to cure the cause of the disease, an integrated approach is needed. If you treat only the manifestations, the cause will not go anywhere. The patient cannot refuse the medicine because he is afraid of the return of unpleasant symptoms. With medicine, a person feels better, but without it, psychological problems return – anxiety is restored, panic attacks are repeated.
• Stage II: physical dependence. Long-term use of alprazolam is addictive, the usual number of tablets no longer works. In this case, you need to adjust the treatment with your doctor, but some patients increase the dose on their own. This is where the key mistake lies. The substance begins to accumulate in the body and is included in metabolic processes.
• stage III: withdrawal syndrome. If you abruptly stop taking the medicine, the patient’s condition will worsen. Drug withdrawal is added to the psychological discomfort. Withdrawal becomes so unbearable that it is easier for a person to take a new dose than to endure this state.

Signs of drug dependence

The very first sign of drug addiction is an acute need for sensations of euphoria, a surge of strength, vivacity, which are caused by a tranquilizer in an increased dosage.

Without taking a narcotic substance, the following are observed:

• irritability, tension, dissatisfaction, capriciousness;
• hypertension;
• tachycardia;
• tremor;
• pale skin.

As time goes on, the symptoms get worse and the withdrawal becomes very severe.

Causes of drug dependence

Addiction is formed as a result of the interaction of biological, psychological and social factors. Heredity, brain injury, example of drinking parents, environment, lack of attention in childhood can play a role in the formation of drug addiction. The reasons can be both obvious and non-obvious. Quite often, quite healthy people from prosperous families become drug addicts, the reason for this may be unresolved psychological problems, general dissatisfaction with life. Creative people can also be addicted in search of inspiration.

The main problem of addiction treatment is that the person denies addiction to the drug. Most drug addicts believe that they can stop using at any time. It is extremely difficult to persuade such a person to be treated.

What is abstinence and how does it manifest itself

Withdrawal syndrome or abstinence is a manifestation of ailments when the dosage of the drug is reduced or when it is canceled. Withdrawal symptoms depend on what exactly the addict uses, on the general state of health, associated addictions, and alcoholism. At the peak of withdrawal, auditory and visual hallucinations, panic attacks, thoughts of suicide can occur. With prolonged use, abstinence can last up to 2-3 weeks, and then for several more months the patient may experience apathy, sleep disturbances, and fatigue.

Manifestations of withdrawal symptoms:

• palpitations;
• abdominal pain, indigestion;
• nausea, vomiting;
• increased sweating;
• jumps in blood pressure;
• pain all over the body;
• feeling of anxiety, fear;
• insomnia at night, drowsiness during the day;
• aggression;
• intolerance to bright light, loud sounds.

At stages 1-2, withdrawal is not so pronounced, the addict is still able to cope with it. The longer the experience of use, the more painful the breakdowns are. The addict sees the only salvation in a new dose of the substance.

Consequences of taking

With prolonged use, the effect of the pills decreases, so the addict increases the dose. To increase the effect, the tranquilizer is mixed with alcohol and other drugs. Because of such experiments, overdoses often occur.

Signs overdose :

• confusion;
• pale skin;
• slow heart rate;
• chills;
• sweating;
• tremor;
• vomiting;
• violation of coordination.

This is a serious medical emergency.

Long-term uncontrolled drug use leads to:

• conduct disorders;
• depression, suicidal ideation;
• neurotic disorders;
• disorders of the liver, kidneys, cardiovascular system;
• deterioration of the brain, difficulty in speech, memory impairment;
• the use of alcohol and other drugs to enhance the effect.

Over time, a person loses his job, old friends, family relationships collapse. The addict may start drinking, stealing. Former values ​​lose all meaning, there is a degradation of the individual.

Xanax addiction prevention

If a doctor has prescribed Xanax for the treatment of serious psychological conditions, it is necessary to strictly observe the dosage and not forget about preventive measures.

• Only a specialized specialist can prescribe a medicine after an examination. It is necessary to exclude contraindications.
• It is important to follow the recommendations during treatment. If you have a feeling that the tranquilizer has stopped working or is causing unpleasant symptoms, be sure to tell your doctor. The specialist will either revise the dosage or prescribe a different medication. It is forbidden to increase the dose on your own to achieve the desired effect.
• Do not drink alcohol during treatment with Xanax. In addition, alprazolam is incompatible with a number of other drugs when used simultaneously.
• Xanax cannot be stopped abruptly. Withdrawal syndrome during withdrawal occurs even in those who took the drug clearly according to the doctor’s instructions. It may take several months to phase out the tranquilizer.

What to do if a person uses Xanax?

If you have a persistent desire to take Xanax, you should immediately contact the doctor who prescribed the tranquilizer. If Xanax was originally used as a narcotic drug, then one cannot do without the help of a narcologist.

Xanax addiction treatment is carried out in stages in the inpatient drug treatment clinic.

First, detoxification is carried out – complete cleansing of the body from alprazolam. Toxins are removed from the body using droppers containing saline, sedatives, vitamins and other components. Detoxification also helps with withdrawal symptoms.

The doctor then prescribes therapy based on the history of use and the general health of the patient. Recovery of the body involves medical procedures, physiotherapy, diet and sleep.

Rehabilitation is of great importance. When the body is cleansed and restored, it is important to consolidate the result. During the course of rehabilitation, the patient visits a psychotherapist, group and individual sessions, restores communication skills, social connections. Be sure to work with the relatives of the patient. Experts recommend going through a rehabilitation course in the treatment of any stage of drug addiction.

Many people ask if it is possible to cure addiction on their own. In rare cases, a person manages to overcome drug addiction on his own. This requires motivation, willpower, the right environment, the ability to cope with withdrawal symptoms without taking drugs. But, unfortunately, most often, independent attempts end up in the search for a new dose, so you can’t ignore the problem in any case. To help yourself or your loved ones, do not hesitate, seek help from specialists.

Xanax. Oral tablets Directory of drugs. Tomsk

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Packaging

Oral tablets

Pharmacological action

Anxiolytic agent (tranquilizer), triazolo-benzodiazepine derivative. It has an anxiolytic, sedative, hypnotic, anticonvulsant, central muscle relaxant effect. The mechanism of action is to enhance the inhibitory effect of endogenous GABA in the CNS by increasing the sensitivity of GABA receptors to the mediator as a result of stimulation of benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brainstem and intercalary neurons of the lateral horns of the spinal cord; reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

Pronounced anxiolytic activity (decrease in emotional stress, weakening of anxiety, fear, anxiety) is combined with a moderately pronounced hypnotic effect; shortens the period of falling asleep, increases the duration of sleep, reduces the number of night awakenings. The mechanism of hypnotic action is to inhibit the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

Indications for use

Anxiety, neurosis, accompanied by a sense of anxiety, danger, restlessness, tension, worsening sleep, irritability, as well as somatic disorders; mixed anxiety-depressive states; neurotic reactive-depressive states, accompanied by a decrease in mood, loss of interest in the environment, anxiety, loss of sleep, loss of appetite, somatic disorders; anxiety states and neurotic depressions that have developed against the background of somatic diseases; panic disorder with and without phobia symptoms.

Release form

tablets 0.25 mg; blister pack 10, carton pack 3;

tablets 0.5 mg; blister pack 10, carton pack 3;

Compound

Tablets 1 tab.

alprazolam 0.25 mg, 0.5 mg

in a blister pack 10 pcs.; in a pack of cardboard 3 packs.

Pharmacodynamics

Anxiolytic agent (tranquilizer), triazolo-benzodiazepine derivative. It has an anxiolytic, sedative, hypnotic, anticonvulsant, central muscle relaxant effect. The mechanism of action is to enhance the inhibitory effect of endogenous GABA in the CNS by increasing the sensitivity of GABA receptors to the mediator as a result of stimulation of benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brainstem and intercalary neurons of the lateral horns of the spinal cord; reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

Pronounced anxiolytic activity (decrease in emotional stress, weakening of anxiety, fear, anxiety) is combined with a moderately pronounced hypnotic effect; shortens the period of falling asleep, increases the duration of sleep, reduces the number of night awakenings. The mechanism of hypnotic action is to inhibit the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

Pharmacokinetics

After oral administration, alprazolam is rapidly and completely absorbed from the gastrointestinal tract. Cmax in plasma is achieved within 1-2 hours.

Plasma protein binding is 80%.

Metabolized in the liver.

T1 / 2 averages 12-15 hours. Alprazolam and its metabolites are excreted mainly by the kidneys.

Use during pregnancy

Alprazolam has a toxic effect on the fetus and increases the risk of congenital malformations when used in the first trimester of pregnancy. Chronic use during pregnancy can lead to physical dependence with the development of withdrawal syndrome in the newborn. Reception in therapeutic doses in later stages of pregnancy can cause depression of the central nervous system of the newborn. Use immediately before or during labor may cause respiratory depression, decreased muscle tone, hypotension, hypothermia, and poor suckling (poor neonatal sucking syndrome) in the neonate.

Benzodiazepines may be excreted in breast milk, which can make the newborn drowsy and make it difficult to feed.

Experimental studies have shown that alprazolam and its metabolites are excreted in breast milk.

Contraindications for use

Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute alcohol poisoning (with weakening of vital functions), opioid analgesics, hypnotics and psychotropic drugs, chronic obstructive airways disease with initial manifestations of respiratory failure, acute respiratory failure, severe depression (suicidal tendencies may appear), pregnancy (especially the first trimester), lactation, children and adolescents under 18 years of age, hypersensitivity to benzodiazepines.

Side effects

From the side of the central nervous system: at the beginning of treatment (especially in elderly patients) drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, gait instability, mental and motor reactions slowdown; rarely – headache, euphoria, depression, tremor, memory loss, impaired coordination of movements, depressed mood, confusion, dystonic extrapyramidal reactions (uncontrolled movements, including the eyes), weakness, myasthenia gravis, dysarthria; in some cases, paradoxical reactions (aggressive outbursts, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia).

On the part of the digestive system: dry mouth or salivation, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea, impaired liver function, increased activity of hepatic transaminases and alkaline phosphatase, jaundice.

On the part of the hematopoietic system: possible leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia.

From the urinary system: possible urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea.

On the part of the endocrine system: possible changes in body weight, libido disorders, menstrual disorders.

From the side of the cardiovascular system: a decrease in blood pressure, tachycardia is possible.

Allergic reactions: possible skin rash, itching.

Method of administration and dosage

Individual. It is recommended to use the minimum effective dose. The dose is adjusted during treatment, depending on the effect achieved and tolerability. If it is necessary to increase the dose, it should be increased gradually, first in the evening, and then in the daytime.

The initial dose is 250-500 mcg 3, if necessary, a gradual increase to 4.5 mg / day is possible.

For elderly or debilitated patients, the initial dose is 250 mcg 2-3 times, maintenance doses are 500-750 mcg / day, if necessary, taking into account tolerance, the dose can be increased.

Cancellation or dose reduction of alprazolam should be carried out gradually, reducing the daily dose by no more than 500 mcg every 3 days; sometimes even slower cancellation may be needed.

Interaction with other drugs

With the simultaneous use of psychotropic, anticonvulsant drugs and ethanol, an increase in the inhibitory effect of alprazolam on the central nervous system is observed.

With simultaneous use of histamine H2 receptor blockers, they reduce the clearance of alprazolam and increase the inhibitory effect of alprazolam on the central nervous system; macrolide antibiotics – reduce the clearance of alprazolam.

With simultaneous use of hormonal contraceptives for oral administration, increase T1 / 2 of alprazolam.

With the simultaneous use of alprazolam with dextropropoxyphene, a more pronounced CNS depression is observed than in combination with other benzodiazepines, tk. it is possible to increase the concentration of alprazolam in the blood plasma.

The simultaneous use of digoxin increases the risk of developing intoxication with cardiac glycosides.

Alprazolam increases the concentration of imipramine in plasma.

With the simultaneous use of itraconazole, ketoconazole enhance the effects of alprazolam.

With the simultaneous use of paroxetine, it is possible to enhance the effects of alprazolam, due to the inhibition of its metabolism.

Fluvoxamine increases the plasma concentration of alprazolam and the risk of its side effects.

With the simultaneous use of fluoxetine, an increase in the concentration of alprazolam in the blood plasma is possible due to a decrease in its metabolism and clearance under the influence of fluoxetine, which is accompanied by psychomotor disorders.