What miligrams do xanax come in. Understanding Xanax: Dosages, Side Effects, and Uses for Anxiety Treatment
What are the available strengths of Xanax. How does Xanax work for anxiety disorders. What are the potential side effects of taking Xanax. How should Xanax be taken safely. What drug interactions are possible with Xanax.
Xanax Dosage Forms and Strengths
Xanax is available as an oral tablet in four different strengths:
- 0.25 milligrams (mg)
- 0.5 mg
- 1 mg
- 2 mg
The tablets come in different shapes and colors corresponding to their strength, making it easier for patients to identify their prescribed dose. Xanax is an immediate-release formulation, meaning the active ingredient alprazolam is released quickly into the body after ingestion.
Xanax vs. Xanax XR
While this article focuses on standard Xanax tablets, it’s worth noting that an extended-release version called Xanax XR also exists. Xanax XR is specifically approved for treating panic disorder and is typically taken once daily. The extended-release formulation allows for a more gradual release of alprazolam over time.
Recommended Dosages for Different Conditions
The appropriate Xanax dosage can vary depending on the condition being treated, individual patient factors, and response to the medication. It’s crucial to follow the dosage prescribed by your healthcare provider.
Dosage for Generalized Anxiety Disorder
For generalized anxiety disorder requiring immediate treatment, the typical starting dosage is:
- 0.25 mg to 0.5 mg taken three times daily
The dosage may be gradually increased every 3 to 4 days if needed, with a maximum recommended daily dose of 4 mg.
Dosage for Panic Disorder
When treating panic disorder with or without agoraphobia, the usual starting dose is:
- 0.5 mg taken three times daily
If necessary, the dosage can be increased slowly, typically by 1 mg every 3 to 4 days. While doses up to 10 mg daily have been reported, it’s uncommon to prescribe such high amounts.
Important Considerations for Xanax Use
Xanax is classified as a controlled substance due to its potential for misuse and dependence. Patients should adhere strictly to their prescribed dosage and never share the medication with others. Proper storage in a secure location away from children is essential.
Duration of Treatment
Xanax is generally not intended for long-term use. The safety and efficacy of Xanax have not been established beyond 10 weeks for panic disorder or 4 months for generalized anxiety disorder. When discontinuing Xanax, a gradual tapering of the dosage under medical supervision is typically recommended to minimize withdrawal symptoms.
Special Dosing Considerations
Certain groups may require dosage adjustments:
- Adults 65 years and older
- Individuals with decreased liver function
- Patients taking ritonavir or other medications that affect Xanax metabolism
In these cases, lower doses of Xanax are usually prescribed to ensure safety and effectiveness.
Potential Side Effects of Xanax
While Xanax can be effective for treating anxiety and panic disorders, it’s important to be aware of potential side effects. Common side effects may include:
- Drowsiness or sedation
- Dizziness
- Memory problems
- Difficulty concentrating
- Dry mouth
- Constipation
- Changes in appetite
More serious side effects, though less common, can occur. These may include:
- Severe drowsiness or confusion
- Mood changes or depression
- Coordination problems
- Slurred speech
- Yellowing of the skin or eyes (jaundice)
- Allergic reactions
Patients should immediately report any concerning symptoms to their healthcare provider.
How Xanax Works to Treat Anxiety
Xanax belongs to a class of medications called benzodiazepines. It works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that helps regulate brain activity. By increasing GABA activity, Xanax can help reduce excessive neuronal firing associated with anxiety and panic disorders.
Onset and Duration of Action
As an immediate-release medication, Xanax typically begins to take effect within 30 minutes to an hour after ingestion. The peak effects are usually felt within 1 to 2 hours. The duration of action can vary but generally lasts for several hours.
Drug Interactions and Precautions
Xanax can interact with various medications and substances, potentially altering its effectiveness or increasing the risk of side effects. Some important interactions to be aware of include:
- Other central nervous system depressants (e.g., alcohol, opioids)
- Certain antidepressants
- Antifungal medications
- Some antibiotics
- HIV protease inhibitors (e.g., ritonavir)
It’s crucial to inform your healthcare provider about all medications, supplements, and herbal products you’re taking to avoid potential interactions.
Pregnancy and Breastfeeding
The use of Xanax during pregnancy and breastfeeding should be carefully considered. There are potential risks to the fetus and newborn, including withdrawal symptoms. Women who are pregnant, planning to become pregnant, or breastfeeding should discuss the risks and benefits of Xanax use with their healthcare provider.
Withdrawal and Dependence Considerations
Xanax can lead to physical dependence, even when taken as prescribed. Abrupt discontinuation can result in withdrawal symptoms, which may include:
- Rebound anxiety
- Insomnia
- Irritability
- Tremors
- Sweating
- Nausea
- Seizures (in severe cases)
To minimize the risk of withdrawal, patients should work closely with their healthcare provider to develop a tapering schedule when discontinuing Xanax. This typically involves gradually reducing the dose over time.
Recognizing Signs of Misuse
Due to its potential for misuse and addiction, it’s important to be vigilant for signs of problematic Xanax use. These may include:
- Taking higher doses than prescribed
- Using Xanax more frequently than directed
- Seeking multiple prescriptions from different providers
- Experiencing strong cravings for the medication
- Neglecting responsibilities due to Xanax use
If you or someone you know is struggling with Xanax misuse, it’s crucial to seek professional help promptly.
Alternatives to Xanax for Anxiety Treatment
While Xanax can be effective for short-term anxiety relief, there are various alternative treatments available for anxiety and panic disorders. These may include:
- Other types of anti-anxiety medications (e.g., SSRIs, SNRIs)
- Cognitive-behavioral therapy (CBT)
- Mindfulness and relaxation techniques
- Lifestyle modifications (e.g., regular exercise, stress management)
- Herbal supplements (under medical supervision)
Discussing these options with a healthcare provider can help determine the most appropriate treatment approach based on individual needs and circumstances.
Combining Treatments for Optimal Results
Many patients find that a combination of medication and psychotherapy yields the best results for managing anxiety and panic disorders. This approach can address both the immediate symptoms and underlying causes of anxiety, potentially leading to more sustainable long-term improvements.
Xanax, when used appropriately under medical supervision, can be an effective tool in managing anxiety and panic disorders. However, it’s crucial to understand the potential risks, side effects, and limitations associated with its use. By working closely with healthcare providers, patients can develop a comprehensive treatment plan that may include Xanax as part of a broader strategy for managing anxiety and improving overall mental health.
Form, Strengths, How to Take, and More
If you have certain anxiety-related conditions, your doctor might suggest Xanax as a treatment option. It’s a prescription drug used to treat the following conditions in adults:
- panic disorder with or without agoraphobia
- generalized anxiety disorder that requires immediate treatment
Xanax comes as a tablet that you swallow. It contains the active ingredient alprazolam. (An active ingredient is what makes a drug work.) Xanax belongs to a group of drugs called benzodiazepines.
This article describes the dosages of Xanax, as well as its strengths and how to take it. To learn more about Xanax, see this in-depth article.
Note: This article covers Xanax’s usual dosages, which are provided by the drugmaker. But when using Xanax, always take the dosage your doctor prescribes.
Xanax vs. Xanax XR
Another form of Xanax is available, which is called Xanax XR. This form of the drug is used to treat panic disorder only.
It’s usually taken once per day.
Xanax tablets are immediate-release, which means all of the drug is released into your body soon after the tablet dissolves.
Xanax XR tablets are extended-release (XR). This means the drug is released slowly into your body over a period of time.
This article focuses just on Xanax. To learn more about Xanax XR’s dosage, talk with your doctor or see the drug’s prescribing information.
Below is information about the usual dosages of Xanax.
Note: This chart highlights the basics of the drug’s dosage. Be sure to read on for more detail.
| Xanax form | Xanax strengths | Xanax starting dosage |
| • tablet | • 0.25 milligrams (mg) • 0.5 mg • 1 mg • 2 mg | • 0.25 mg to 0.5 mg three times per day |
Note: Xanax is a controlled substance. This means it’s regulated by the U.
S. government due to the risk of misuse. (With misuse a drug is taken in a way other than how it’s prescribed.) You should only take Xanax exactly as prescribed and you should not share the drug with anyone else. It’s also recommended that you store Xanax in a safe place away from children.
What are the forms of Xanax?
Xanax comes as a tablet that you swallow.
What strengths does Xanax come in?
Xanax comes in the following strengths:
- 0.25 mg
- 0.5 mg
- 1 mg
- 2 mg
Different Xanax strengths come in different shapes and colors which can help you remember the strength of your tablet.
What are the usual dosages of Xanax?
Your doctor will likely start you on a low dosage of Xanax and adjust it over time to reach the right amount for you. Instead of increasing your dose to reach an average dosage, they’ll prescribe the smallest dosage that provides the desired effect.
The information below describes dosages that are commonly used or recommended.
But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
Dosage for generalized anxiety disorder
You’ll likely start by taking Xanax 0.25-mg to 0.5-mg tablets three times daily. Then, if you respond well to the drug, your doctor may increase your dosage slowly. The increase is usually once every 3 to 4 days. The maximum dosage recommended by the drugmaker is 4 mg daily.
Dosage for panic disorder
You’ll likely start with Xanax 0.5-mg tablets three times per day. If you respond well to the drug and your doctor increases your daily dosage, they’ll do it slowly by 1 mg every 3 to 4 days. The highest dose reported by the drugmaker is 10 mg daily, but it’s uncommon to take that high of a dose.
Taper
When you stop taking Xanax, your doctor will likely have you decrease your dose slowly. See the “Xanax and withdrawal and dependence” section below.
What’s the dosage of Xanax for children?
There’s no recommended Xanax dosage for children, though doctors sometimes prescribe the drug off-label for them.
(Off-label use is when a drug is prescribed to treat a condition or age group it hasn’t been approved for.) To learn more about the uses and risks of Xanax in children, talk with your child’s doctor.
Is Xanax used long term?
No, Xanax is not usually used as a long-term treatment. It’s not known if Xanax is safe to take for more than 10 weeks for panic disorder or more than 4 months for generalized anxiety disorder.
When stopping Xanax, you’ll likely do it slowly using a taper schedule. This will help decrease your risk of withdrawal symptoms. (These are side effects that can happen when you stop taking a drug your body has become dependent on.) Talk with your doctor about what your dosage taper schedule will be.
Dosage adjustments
If you’re an adult ages 65 years and older, if you have decreased liver function, or if you take a drug called ritonavir, your doctor will prescribe a lower Xanax dosage. There are specific dosing guidelines for taking Xanax with ritonavir.
Your Xanax dose will also be decreased if you’re taking other medications that cause your liver to process Xanax more slowly. If you still have side effects, your doctor may decrease your dose further. There’s not a specific lowest dose that’s usually prescribed.
Some drugs affect liver function so much that they’re not safe to take with Xanax at all. Examples include Prezista (darunavir) and Noxafil (Posaconazole). If you need to take one of these drugs, your doctor will likely have you stop your Xanax treatment with a taper first.
Below are answers to some common questions about Xanax and dosage.
Is the dosage of Xanax based on body weight?
No, your dosage of Xanax is not based on your body weight. You’ll likely start on a low dose and your doctor may increase it slowly based on your reaction to the drug.
What is a Xanax bar?
A Xanax bar usually refers to a Xanax tablet that’s shaped like a rectangle. This wording is often used in the context of misuse and addiction.
(Misuse means a drug is taken differently than how it was prescribed. Addiction means a drug is used even if it leads to harmful outcomes.)
For more information about the risks of misuse and addiction with Xanax, see the boxed warning at the start of this article).
Xanax and Xanax XR come in several different shapes and colors. This is helpful when your doctor prescribes more than one strength of Xanax to make up your daily dose.
Is Xanax used for insomnia? If so, what’s the dosage?
Xanax is sometimes used off-label* for insomnia. If your doctor prescribes Xanax for this condition, they’ll determine the dosage that’s right for you.
While off-label uses are often safe and effective, you may be able to find an option for insomnia that’s safer than Xanax. Benzodiazepines (the drug group Xanax belongs to) have a higher risk of dependence and withdrawal symptoms than other drugs that treat insomnia. (With dependence your body gets used to a drug and needs it for you to feel comfortable.
And withdrawal symptoms are side effects that can occur when you stop taking a drug your body has become dependent on.)
Is there a Xanax dosage used for dental work or before other medical procedures?
Xanax has been used off-label* to help with anxiety and sedation before medical procedures, including dental work. There is not a specific dose that’s always used for this purpose.
Another drug used for this purpose is Valium (diazepam), which (like Xanax) is a benzodiazepine. Find out more about the similarities and differences between Xanax and Valium in this article.
Talk with your doctor or dentist if you have anxiety before medical procedures.
* Off-label use is when a drug is prescribed to treat a condition or age group it hasn’t been approved for.
The dosage of Xanax you’re prescribed may depend on several factors. These include:
- the type and severity of the condition you’re using the drug to treat
- your age
- the form of Xanax you take
- side effects you may have from Xanax
- other medications you take
- other conditions you may have (see “Dosage adjustments” above)
Xanax comes as a tablet you swallow with water, usually three times per day.
You can take it with or without food.
For information on the expiration, storage, and disposal of Xanax, see this article.
Accessible drug containers and labels
If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:
- have large print or use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Xanax in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.
If you miss your Xanax dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take the next one at the usual time. Don’t take two doses at once.
If you need help remembering to take your dose of Xanax on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Do not take more Xanax than your doctor prescribes, as this can lead to serious side effects. The drugmaker reports that overdoses have happened with Xanax alone and when Xanax was combined with other drugs or alcohol.
Symptoms of overdose
Symptoms caused by an overdose can include:
- confusion
- extreme drowsiness
- lack of coordination
- slow reflexes
- death (in rare cases)
What to do in case you take too much Xanax
Call your doctor right away if you think you’ve taken too much Xanax. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room. A drug called flumazenil is sometimes used along with other measures to treat an overdose of benzodiazepines (the drug group Xanax belongs to).
Xanax
Xanax has a boxed warning for withdrawal reactions. (See the beginning of this article for more details on the boxed warnings for Xanax.) Withdrawal reactions are more likely in people who take higher doses and people who take the drug for a longer amount of time. Symptoms of these reactions include:
- blurry vision
- dizziness
- depression
- anxiety
- uncontrolled movements
- insomnia
- seizure
- hallucinations
- suicidal thoughts
Long-term withdrawal symptoms that can last weeks to 12 months or more include:
- ringing in the ears
- muscle twitches
- numbness
- cognitive difficulty
Your doctor will likely prescribe a dosage taper schedule to help you avoid withdrawal reactions. Your daily dose will likely be decreased by 0.5 mg in 3-day (or longer) intervals. If you have any symptoms of withdrawal, talk with your doctor right away. They may decide to pause or slow your taper schedule.
The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Xanax for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Xanax without your doctor’s recommendation. Only take Xanax exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage. Here are some examples of questions you may want to ask:
- How slow should my Xanax dosage taper be?
- If I take a lower dose of Xanax, will I have a lower risk of side effects?
- Will my dosage of Xanax change if I start another medication?
- Will I take a lower Xanax dosage if I have liver problems?
To get information on different conditions, and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Disclaimer: Healthline 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.
Form, Strengths, How to Take, and More
If you have certain anxiety-related conditions, your doctor might suggest Xanax as a treatment option. It’s a prescription drug used to treat the following conditions in adults:
- panic disorder with or without agoraphobia
- generalized anxiety disorder that requires immediate treatment
Xanax comes as a tablet that you swallow.
It contains the active ingredient alprazolam. (An active ingredient is what makes a drug work.) Xanax belongs to a group of drugs called benzodiazepines.
This article describes the dosages of Xanax, as well as its strengths and how to take it. To learn more about Xanax, see this in-depth article.
Note: This article covers Xanax’s usual dosages, which are provided by the drugmaker. But when using Xanax, always take the dosage your doctor prescribes.
Xanax vs. Xanax XR
Another form of Xanax is available, which is called Xanax XR. This form of the drug is used to treat panic disorder only. It’s usually taken once per day.
Xanax tablets are immediate-release, which means all of the drug is released into your body soon after the tablet dissolves.
Xanax XR tablets are extended-release (XR). This means the drug is released slowly into your body over a period of time.
This article focuses just on Xanax. To learn more about Xanax XR’s dosage, talk with your doctor or see the drug’s prescribing information.
Below is information about the usual dosages of Xanax.
Note: This chart highlights the basics of the drug’s dosage. Be sure to read on for more detail.
| Xanax form | Xanax strengths | Xanax starting dosage |
| • tablet | • 0.25 milligrams (mg) • 0.5 mg • 1 mg • 2 mg | • 0.25 mg to 0.5 mg three times per day |
Note: Xanax is a controlled substance. This means it’s regulated by the U.S. government due to the risk of misuse. (With misuse a drug is taken in a way other than how it’s prescribed.) You should only take Xanax exactly as prescribed and you should not share the drug with anyone else. It’s also recommended that you store Xanax in a safe place away from children.
What are the forms of Xanax?
Xanax comes as a tablet that you swallow.
What strengths does Xanax come in?
Xanax comes in the following strengths:
- 0.
25 mg - 0.5 mg
- 1 mg
- 2 mg
25 mgDifferent Xanax strengths come in different shapes and colors which can help you remember the strength of your tablet.
What are the usual dosages of Xanax?
Your doctor will likely start you on a low dosage of Xanax and adjust it over time to reach the right amount for you. Instead of increasing your dose to reach an average dosage, they’ll prescribe the smallest dosage that provides the desired effect.
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
Dosage for generalized anxiety disorder
You’ll likely start by taking Xanax 0.25-mg to 0.5-mg tablets three times daily. Then, if you respond well to the drug, your doctor may increase your dosage slowly. The increase is usually once every 3 to 4 days. The maximum dosage recommended by the drugmaker is 4 mg daily.
Dosage for panic disorder
You’ll likely start with Xanax 0.5-mg tablets three times per day. If you respond well to the drug and your doctor increases your daily dosage, they’ll do it slowly by 1 mg every 3 to 4 days. The highest dose reported by the drugmaker is 10 mg daily, but it’s uncommon to take that high of a dose.
Taper
When you stop taking Xanax, your doctor will likely have you decrease your dose slowly. See the “Xanax and withdrawal and dependence” section below.
What’s the dosage of Xanax for children?
There’s no recommended Xanax dosage for children, though doctors sometimes prescribe the drug off-label for them. (Off-label use is when a drug is prescribed to treat a condition or age group it hasn’t been approved for.) To learn more about the uses and risks of Xanax in children, talk with your child’s doctor.
Is Xanax used long term?
No, Xanax is not usually used as a long-term treatment. It’s not known if Xanax is safe to take for more than 10 weeks for panic disorder or more than 4 months for generalized anxiety disorder.
When stopping Xanax, you’ll likely do it slowly using a taper schedule. This will help decrease your risk of withdrawal symptoms. (These are side effects that can happen when you stop taking a drug your body has become dependent on.) Talk with your doctor about what your dosage taper schedule will be.
Dosage adjustments
If you’re an adult ages 65 years and older, if you have decreased liver function, or if you take a drug called ritonavir, your doctor will prescribe a lower Xanax dosage. There are specific dosing guidelines for taking Xanax with ritonavir.
Your Xanax dose will also be decreased if you’re taking other medications that cause your liver to process Xanax more slowly. If you still have side effects, your doctor may decrease your dose further. There’s not a specific lowest dose that’s usually prescribed.
Some drugs affect liver function so much that they’re not safe to take with Xanax at all. Examples include Prezista (darunavir) and Noxafil (Posaconazole).
If you need to take one of these drugs, your doctor will likely have you stop your Xanax treatment with a taper first.
Below are answers to some common questions about Xanax and dosage.
Is the dosage of Xanax based on body weight?
No, your dosage of Xanax is not based on your body weight. You’ll likely start on a low dose and your doctor may increase it slowly based on your reaction to the drug.
What is a Xanax bar?
A Xanax bar usually refers to a Xanax tablet that’s shaped like a rectangle. This wording is often used in the context of misuse and addiction. (Misuse means a drug is taken differently than how it was prescribed. Addiction means a drug is used even if it leads to harmful outcomes.)
For more information about the risks of misuse and addiction with Xanax, see the boxed warning at the start of this article).
Xanax and Xanax XR come in several different shapes and colors. This is helpful when your doctor prescribes more than one strength of Xanax to make up your daily dose.
Is Xanax used for insomnia? If so, what’s the dosage?
Xanax is sometimes used off-label* for insomnia. If your doctor prescribes Xanax for this condition, they’ll determine the dosage that’s right for you.
While off-label uses are often safe and effective, you may be able to find an option for insomnia that’s safer than Xanax. Benzodiazepines (the drug group Xanax belongs to) have a higher risk of dependence and withdrawal symptoms than other drugs that treat insomnia. (With dependence your body gets used to a drug and needs it for you to feel comfortable. And withdrawal symptoms are side effects that can occur when you stop taking a drug your body has become dependent on.)
Is there a Xanax dosage used for dental work or before other medical procedures?
Xanax has been used off-label* to help with anxiety and sedation before medical procedures, including dental work. There is not a specific dose that’s always used for this purpose.
Another drug used for this purpose is Valium (diazepam), which (like Xanax) is a benzodiazepine.
Find out more about the similarities and differences between Xanax and Valium in this article.
Talk with your doctor or dentist if you have anxiety before medical procedures.
* Off-label use is when a drug is prescribed to treat a condition or age group it hasn’t been approved for.
The dosage of Xanax you’re prescribed may depend on several factors. These include:
- the type and severity of the condition you’re using the drug to treat
- your age
- the form of Xanax you take
- side effects you may have from Xanax
- other medications you take
- other conditions you may have (see “Dosage adjustments” above)
Xanax comes as a tablet you swallow with water, usually three times per day. You can take it with or without food.
For information on the expiration, storage, and disposal of Xanax, see this article.
Accessible drug containers and labels
If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist.
Some pharmacies provide medication labels that:
- have large print or use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Xanax in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.
If you miss your Xanax dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take the next one at the usual time. Don’t take two doses at once.
If you need help remembering to take your dose of Xanax on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Do not take more Xanax than your doctor prescribes, as this can lead to serious side effects.
The drugmaker reports that overdoses have happened with Xanax alone and when Xanax was combined with other drugs or alcohol.
Symptoms of overdose
Symptoms caused by an overdose can include:
- confusion
- extreme drowsiness
- lack of coordination
- slow reflexes
- death (in rare cases)
What to do in case you take too much Xanax
Call your doctor right away if you think you’ve taken too much Xanax. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room. A drug called flumazenil is sometimes used along with other measures to treat an overdose of benzodiazepines (the drug group Xanax belongs to). Xanax
Xanax has a boxed warning for withdrawal reactions. (See the beginning of this article for more details on the boxed warnings for Xanax.
) Withdrawal reactions are more likely in people who take higher doses and people who take the drug for a longer amount of time. Symptoms of these reactions include:
- blurry vision
- dizziness
- depression
- anxiety
- uncontrolled movements
- insomnia
- seizure
- hallucinations
- suicidal thoughts
Long-term withdrawal symptoms that can last weeks to 12 months or more include:
- ringing in the ears
- muscle twitches
- numbness
- cognitive difficulty
Your doctor will likely prescribe a dosage taper schedule to help you avoid withdrawal reactions. Your daily dose will likely be decreased by 0.5 mg in 3-day (or longer) intervals. If you have any symptoms of withdrawal, talk with your doctor right away. They may decide to pause or slow your taper schedule.
The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Xanax for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Xanax without your doctor’s recommendation. Only take Xanax exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage. Here are some examples of questions you may want to ask:
- How slow should my Xanax dosage taper be?
- If I take a lower dose of Xanax, will I have a lower risk of side effects?
- Will my dosage of Xanax change if I start another medication?
- Will I take a lower Xanax dosage if I have liver problems?
To get information on different conditions, and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.
Disclaimer: Healthline 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.
addiction, harm, treatment at the Rehab Family clinic
Xanax is an effective drug from the benzodiazepine group. The drug is used to treat a variety of conditions in the clinical picture of which anxiety is present.
When properly used and taken in prescribed dosages, a tranquilizer has a good therapeutic effect.
The increased interest of drug addicts is associated with the ability of Xanax to induce a state of mild euphoria, reduce the severity of withdrawal symptoms and the level of anxiety./cloudfront-us-east-1.images.arcpublishing.com/gray/WOIDMTEQMZJA3OD4IO67T65OWA.jpg)
Uncontrolled use of Xanax is a problem that is known to specialists in various fields of medicine.
Xanax – description, composition, effect, properties
Xanax (alprazolam) is a benzodiazepine anxiolytic with a medium duration of action.
The drug first appeared on the pharmaceutical market in the early 80s of the last century and has found wide application in medicine.
The active substance is alprazolam. The preparation also contains auxiliary components: potato starch, lactose, magnesium stearate, etc.
Available in tablet form of 0.25, 0.5 and 2 mg and retard tablets of 0.5 mg.
Officially, Xanax can only be purchased with a prescription from the attending physician, written out on special forms.
Alprazolam to varying degrees has all the properties of classical benzodiazepines.
It has a pronounced anti-anxiety, soothing, muscle-relaxing, anticonvulsant effect, improves sleep quality.
A characteristic feature is an anti-panic effect, in connection with which the drug is prescribed for panic disorders. According to some reports, it has some antidepressant effect.
Most effective in the treatment of disorders with a pronounced anxiety component.
The spectrum of activity of Xanax determines the main indications for its use. These include:
- panic attacks;
- anxiety states, mixed anxiety-depressive disorder;
- neuroses;
- increased irritability, internal tension;
- depressive states;
- obsessive-compulsive disorder;
- psychomotor agitation;
- simple and social phobias;
- sleep problems, appetite disorders;
- withdrawal syndrome in alcoholism and drug addiction;
- a feeling of anxiety and anxiety in a number of somatic diseases;
- tremor of the limbs.
To prevent undesirable consequences of use, it is important to consider contraindications to the use of an anxiolytic:
- individual intolerance;
- angle-closure glaucoma;
- severe damage to the cardiovascular system, respiratory organs, liver, kidneys;
- myasthenia gravis;
- poisoning with alcohol and psychoactive substances;
- depression with suicidal tendencies;
- the period of pregnancy and breastfeeding;
- age up to 18 years.
With prolonged use and excess dosages, Xanax is addictive and highly addictive.
The effect of the drug on the human body
The active substance of the drug has a depressant effect on the central nervous system.
The mechanism of action of Xanax on the body is based on an increase in the inhibitory effect in the brain and a decrease in the excitability of subcortical structures: the limbic system, hypothalamus, and thalamus.
The drug is an agonist (stimulator) of specific benzodiazepine receptors. By binding to the GABA-A receptor complex, the affinity and sensitivity to the mediator increases. The GABA-ergic system is activated, the frequency of opening of chloride channels and the flow of chlorine into the neuron increase. This leads to suppression of neuronal activity and inhibition of the transmission of nerve impulses.
One of the differences between Xanax and other tranquilizers is less pronounced sedation and behavioral toxicity, which is manifested by daytime sleepiness, a decrease in the severity of reactions and cognitive functions.
The main effects of Xanax:
- Pronounced anxiolytic (anti-anxiety): reduces the feeling of fear, anxiety, emotional stress.
- Moderate sedation.
- Increases the duration of sleep, promotes rapid falling asleep.
- Central muscle relaxant, which occurs as a result of inhibition of the spinal reflexes of the brain stem.
- Anticonvulsant.
With an increase in the dose of the drug, there is a slight euphoria, a feeling of comfort, calmness, peace, relaxation. To obtain such sensations, the drug is often used by drug addicts.
Drug dependence
When using alprazolam for medical purposes, as prescribed by a doctor, addiction develops slowly.
Gradually, adaptation to the action of the drug occurs, and it loses its medicinal properties. Therefore, it is necessary to increase the dose or change the drug. A safe treatment regimen in these cases is selected by a specialist.
With prolonged use of a tranquilizer to achieve a narcotic effect, addiction occurs within 2-3 months. A decrease in the intensity of the body’s reaction to repeated administration of a substance leads to the need to increase the dose to obtain the same effect.
As a result of abuse, dependence on Xanax develops, which is manifested by a strong and uncontrollable desire to use the drug. The likelihood of dependence is especially high in people suffering from alcoholism, drug addiction, personality disorder.
Against the background of taking an anxiolytic, there is a feeling of physical and mental comfort, well-being, self-confidence. The concentration of attention decreases, the sense of danger, the surrounding reality can be perceived in a distorted form.
Signs of Xanax use:
- a feeling of a surge of strength and energy;
- increased mood, mild euphoria;
- drops in blood pressure;
- tachycardia;
- pallor of the skin;
- trembling of the limbs;
- loss of appetite.
Outside the state of intoxication, irritability, dissatisfaction, discomfort, internal tension appear. If symptoms suggestive of drug abuse appear, it is recommended to contact a specialist in a mental health clinic.
How long does Xanax stay in the body and how is it excreted?
Xanax is a medium-acting benzodiazepine with an average half-life of 12-15 hours.
After oral administration, it is well absorbed from the gastrointestinal tract. Bioavailability is high (about 90%).
The maximum content in the blood plasma is reached after 1-2 hours. Plasma protein binding is 70-80%.
The drug is metabolized in the liver with the participation of cytochrome P450 with the formation of two metabolites.
Alprazolam and its metabolites are excreted mainly unchanged in the urine, a small part through the intestines.
Stages and types of drug dependence
Long-term use of large doses of the substance leads to an increase in tolerance and the development of psychological dependence. The timing of its formation depends on a number of factors: experience of use, dosage, susceptibility of the organism, state of health.
By reducing the dose of the drug, a person experiences discomfort, feels depressed and tense. To get rid of negative symptoms, the addict returns to taking the substance.
With continued use of alprazolam as a narcotic drug, physical dependence occurs, a characteristic manifestation of which is withdrawal syndrome (abstinence).
Withdrawal symptoms:
- anxiety, fussiness, irritability;
- depression, apathy;
- deterioration in general well-being;
- excessive sweating;
- malaise, weakness;
- heart palpitations, high blood pressure;
- pain in the region of the heart;
- lack of appetite;
- nausea, vomiting, dizziness;
- insomnia;
- involuntary muscle twitches, spasms.
In severe cases, at the peak of abstinence, hallucinations, psychomotor agitation, and suicidal intentions are possible.
Side effects of this drug
Excessive passion for Xanax leads to chronic intoxication and serious health consequences. These include:
- violation of the functions of internal organs;
- deterioration of mental abilities, absent-mindedness, forgetfulness, decreased memory and attention;
- behavioral disorders: impulsiveness, irascibility, aggressiveness;
- depression, suicidal behavior;
- neurotic states.
Among the main side effects are the following:
- slowness of motor and mental reactions;
- headache, dizziness;
- dry mouth, increased salivation;
- loss of appetite;
- dyspeptic symptoms;
- unsteady gait;
- deterioration of liver and kidney function;
- urination disorders: urinary incontinence or retention;
- skin rashes.
To enhance the effect, the dependent person constantly increases the dose or mixes the drug with other substances. This is fraught with an overdose – a dangerous condition that requires emergency medical attention.
Signs of a Xanax overdose are:
- lethargy, drowsiness;
- disorientation in the environment;
- inhibited state;
- slow heart rate;
- weakness, chills;
- shortness of breath, oppressed breathing;
- nausea, vomiting;
- tremor;
- impaired coordination of movements.
The severity of symptoms can vary from mild poisoning to severe intoxication. Severe cases lead to impaired consciousness and coma.
Overdose often occurs in addicts who take Xanax with alcohol or other CNS depressants.
Combination of the drug with other substances
The combination of alprazolam with other drugs can lead to irreversible consequences.
The joint use of Xanax and alcohol is unacceptable, since the anxiolytic enhances the effect of ethanol and increases the likelihood of acute intoxication. This is dangerous by inhibition of cardiac and respiratory activity up to the complete cessation of breathing and cardiac arrest.
Other tranquilizers, sleeping pills, opioid analgesics should not be used simultaneously with alprazolam.
Drug dependence affects the quality of life, performance and social activity of the patient. Not only the addict himself suffers from its consequences, but also his relatives.
Relationships in the family worsen, conflicts arise at work, former interests and contacts are lost.
Don’t neglect the health of your loved one. Timely assistance of specialists and constant support of relatives at all stages of treatment will help to cope with the problem and get rid of addiction.
You should not, also, self-medicate, use traditional medicine, turn to “healers” without a medical education.
This can lead to dire consequences.
You need to contact only specialized medical centers, where highly qualified specialists with relevant experience work.
Diagnosis and treatment
An accurate diagnosis is established only by a specialist after diagnosing dependence on Xanax. An important role is played by the data of anamnesis, conversation, general examination and assessment of the mental status of the patient.
It is necessary to pay attention to changes in the character, habits, appearance, behavior of an addicted person, which may indicate the presence of a disease.
To completely get rid of addiction, complex therapy and the help of a team of specialists are needed.
It is important to understand that it is impossible to cope with the problem on your own.
Treatment is carried out in stationary conditions under the supervision of doctors and medical personnel. Therapeutic measures are aimed at stopping the intake of the substance, preventing relapses, resolving intra-family and social conflicts, controlling behavior and emotional state, and returning to a full life.
The first stage of treatment is detoxification, which is carried out to completely cleanse the body, remove toxic products, and stop the withdrawal syndrome.
Symptomatic drug therapy is necessary to relieve somatic and neurological disorders, normalize impaired functions, correct behavioral disorders, and eliminate the negative consequences of taking the drug. For this purpose, painkillers, antispasmodics, anticonvulsants, antihypertensives, vitamins, nootropics and other drugs are prescribed.
Important stages of the treatment program are the course of psychotherapy and rehabilitation. Psychotherapeutic sessions help to realize the presence of an addiction, create motivation to eliminate it, overcome psychological dependence and stop using an anxiolytic.
Rehabilitation helps to fully adapt to life in society. The former addict returns to society, can work, independently solve problems and build full-fledged relationships in the family.
After the end of therapy, in order to prevent relapses, it is desirable to create an optimal microclimate and a friendly environment.
In addition to special psychotherapeutic techniques, you should observe the daily routine, eat right, and exercise.
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Prevention or advice
Xanax, which is addictive due to abuse, requires special care when used as a drug. The drug is prescribed in short courses and canceled, gradually reducing the dosage.
The main condition for safe treatment and the absence of abstinence is gradual withdrawal.
When treating with alprazolam, it is important to follow some recommendations:
- apply a tranquilizer strictly according to indications, under the supervision of a specialist;
- before starting to take into account contraindications, possible risks and adverse reactions;
- if you experience unpleasant symptoms, contact your doctor immediately;
- it is forbidden to independently adjust and increase the dose of the drug;
- remember about compatibility and interaction with other substances.
In order to prevent dependence on Xanax, it is necessary to identify the first signs of tranquilizer abuse as early as possible and refuse to take it.
The first step in the treatment and prevention of addiction is to contact a competent doctor in a specialized clinic.
References:
- Fursov B.B., Papsuev O.O., The use of alprazolam in clinical practice, Social and clinical psychiatry, 2012, v.22, No. 1.
- Medvetsky A.I., General characteristics, application in medicine, methods of qualitative and quantitative analysis of Alprazolam, Far Eastern Medical Journal, 2013
- Kalinin V.V., Xanax preparation. Application in clinical practice // New drugs, 1998, No. 12
- Clinical pharmacology. Textbook. 2nd ed., revised. and additional Kuznetsova N.V. — 2021
💊 Ingredients of Xanax ® ✅ Use of Xanax ® Save Search for analogues ⚠️ The state registration of this drug has been canceled Description of the active ingredients of the preparation Xanax ® The scientific information provided is general and cannot be used to make decisions. Update date: 2020.11.07 Marketing authorization holder: PHARMACIA, NV/SA ATX code: N05BA12 (Alprazolam) Active substance: Rec. WHO registered Dosage form
Release form, packaging and composition |
INN
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.
Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.
| F32 | Depressive episode |
| F33 | Recurrent depressive disorder |
| F40 | Phobic anxiety disorders (including agoraphobia, social phobias) |
| F41.0 | Panic disorder [episodic paroxysmal anxiety] |
| F41.2 | Mixed anxiety and depressive disorder |
| F45.3 | Somatoform dysfunction of the autonomic nervous system |
| F48.0 | Neurasthenia |
| F48.9 | Neurotic disorder, unspecified |
F51. 2 | Sleep and wakefulness disorders of non-organic etiology |
Dosing regimen
The method of administration and dosing regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed.
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 times / day, 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 / day, maintenance doses – 500-750 mcg / day, if necessary, taking into account tolerability, the dose can be increased.
Cancel or reduce the dose of alprazolam should be carried out gradually, reducing the daily dose by no more than 500 micrograms every 3 days; sometimes even slower cancellation may be needed.
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, unsteadiness of gait, slowing down of mental and motor reactions; 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: possible dry mouth or salivation, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea, impaired liver function, increased activity of liver 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: Urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea are possible.
On the part of the endocrine system: possible changes in body weight, libido disorders, menstrual cycle disorders.
From the side of the cardiovascular system: possible decrease in blood pressure, tachycardia.
Allergic reactions: possible skin rash, itching.
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 insufficiency, acute respiratory failure, severe depression (suicidal tendencies may occur), pregnancy (especially the first trimester), lactation, children and adolescents under 18 years of age, hypersensitivity to benzodiazepines.
Use during pregnancy and lactation
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 may make the newborn drowsy and make feeding difficult.
experimental studies show that alprazolam and its metabolites are excreted in breast milk.
Use in hepatic impairment
Alprazolam should be used with caution in patients with hepatic impairment.
Use in Impaired Renal Function
Alprazolam should be used with caution in patients with impaired renal function.
Use in children
Contraindication: children and adolescents under 18 years of age.
Use in elderly patients
For elderly or debilitated patients, the initial dose is 250 mcg 2-3 times / day, maintenance doses – 500-750 mcg / day, if necessary, taking into account tolerability, the dose can be increased.
Special instructions
In endogenous depression, alprazolam can be used in combination with antidepressants. When using alprazolam in patients with depression, there have been cases of the development of hypomanic and manic states.
Alprazolam should be used with caution in patients with hepatic and/or renal impairment.
In patients who have not previously taken drugs that affect the central nervous system, alprazolam is effective at lower doses compared with patients who received antidepressants, anxiolytics or suffering from chronic alcoholism.
With long-term use in high doses, the development of addiction and the formation of drug dependence is possible, especially in patients prone to drug abuse.
With rapid dose reduction or abrupt withdrawal of alprazolam, a withdrawal syndrome occurs, the symptoms of which can range from mild dysphoria and insomnia to a severe syndrome with abdominal and skeletal muscle cramps, vomiting, increased sweating, tremors and convulsions. The withdrawal syndrome is more common in individuals who have received alprazolam for a long time (more than 8-12 weeks).
Other tranquilizers should not be co-administered with alprazolam.
The safety of alprazolam in children and adolescents under 18 years of age has not been established. Children, especially at a younger age, are very sensitive to the inhibitory effect of benzodiazepines on the central nervous system.
Avoid drinking alcohol during treatment.
Influence on the ability to drive vehicles and mechanisms
During the period of treatment, one should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions (driving vehicles or working with mechanisms).
Drug interactions
With the simultaneous use of psychotropic, anticonvulsants, drugs and ethanol, an increase in the inhibitory effect of alprazolam on the central nervous system is observed.
With simultaneous use of blockers of histamine H 2 receptors 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 the simultaneous use of hormonal contraceptives for oral administration increase T 1/2 alprazolam.
With the simultaneous use of alprazolam with dextropropoxyphene, 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.
Simultaneous intake of digoxin increases the risk of developing intoxication with cardiac glycosides.
Alprazolam increases the plasma concentration of imipramine.