Xanax (Alprazolam) - Oral

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What Is Xanax?

Xanax (alprazolam) is a prescription medication often prescribed to treat anxiety and panic disorders. Xanax belongs to a class of medications called benzodiazepines. Benzodiazepines work in the central nervous system on specific receptors in the brain to help boost the activity of the chemical gamma-aminobutyric acid (GABA), which creates a calming effect.

Xanax oral tablets come in immediate-release and extended-release forms, as well as an orally disintegrating form. Alprazolam is also available as an oral solution.

Alprazolam is classified as a Schedule IV controlled substance, meaning it has a lower potential for abuse or dependence relative to medications in higher scheduling categories. Suddenly stopping Xanax or reducing your dose too quickly can sometimes cause life-threatening withdrawal reactions.

The Food and Drug Administration (FDA) also issued a warning against the use of benzodiazepines such as Xanax with opioids. Taking benzodiazepines at the same time as opioids can cause severe drowsiness, breathing problems (respiratory depression), coma, and death.

Drug Facts

  • Generic Name: Alprazolam
  • Brand Name(s): Xanax, Xanax XR, Niravam, Gabazolamine-0.5
  • Administration Route(s): Oral
  • Drug Availability: Prescription
  • Therapeutic Classification: Anti-anxiety
  • Available Generically: Yes
  • Controlled Substance: Potential for abuse
  • Active Ingredient: Alprazolam
  • Dosage Form(s): Tablet, solution

What Is Xanax Used For?

Many people use Xanax to manage the symptoms of anxiety disorders or panic disorders. Usually, anxiety caused by the stress of everyday life doesn’t need to be treated with Xanax.

Generalized anxiety disorder is characterized by excessive or unrealistic worry about two or more life circumstances for longer than six months. During this time, a person spends more days bothered by these concerns than not.

Panic disorder is characterized by regular unexpected panic attacks. A panic attack is a short period of intense fear or discomfort where someone may experience certain symptoms (e.g., pounding heart, trembling or shaking, chest pain, or sweating) that come on suddenly.

How to Take Xanax

Take Xanax by mouth as prescribed by your healthcare provider.

The dosage may be based on any of the following factors:

  • Why you are taking the drug
  • Your age
  • Other medical conditions you may have
  • How your body responds to the drug
  • The form of Xanax you are taking

Your provider may start you on a low dose and gradually increase it over time to find the most effective dose for you. Follow your provider’s instructions closely to help reduce your risk of side effects.

Do not crush, chew, or break the extended-release Xanax tablet. These tablets are meant to be swallowed whole, as they are specially made to release the drug slowly into the body.

Taking Xanax for a long time or at higher doses can result in withdrawal symptoms if the medication is suddenly stopped. To prevent this, a healthcare provider may reduce your dose gradually over time.

Storage

Store Xanax at a controlled room temperature, which is about 68 F to 77 F.

Always carry your medication with you while traveling. If you are flying, make sure to keep the original prescription-labeled bottle or box in your carry-on bag. Don’t leave this medication in your car, especially in cold or hot temperatures.

How Long Does Xanax Take to Work?

You will begin to feel the effects of Xanax within an hour. Xanax reaches its peak concentrations in your bloodstream one to two hours after you take it. However, it can take as long as 10 hours for the extended-release tablets to reach peak.

What Are the Side Effects of Xanax?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Like most medications, Xanax carries a risk for both mild and severe side effects. Typically, side effects occur at the beginning of treatment and go away over time.

Common Side Effects

The most common side effects of alprazolam include:

  • Dizziness or lightheadedness
  • Drowsiness
  • Blurred vision
  • Headache
  • Memory problems
  • Sleep problems
  • Trouble concentrating
  • Dry mouth
  • Constipation
  • Diarrhea
  • Nausea or vomiting
  • Muscle weakness
  • Change in appetite
  • Lack of enthusiasm
  • Loss of interest in sex

Talk to your healthcare provider or pharmacist if these side effects don’t go away or become more severe.

Severe Side Effects

Contact your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. 

Serious side effects and their symptoms can include the following:

  • Hives
  • Difficulty breathing
  • Swelling of the face, tongue, lips, or throat
  • Depressed mood
  • Suicidal thoughts
  • Confusion or hallucinations
  • Seizures or tremors
  • Chest pain
  • Abnormal heartbeat
  • Urinating less than usual or not at all
  • Jaundice (yellowing of the skin)

Report Side Effects

Xanax may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Xanax Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For anxiety:

For oral dosage forms (solution, tablets, or orally disintegrating tablets):

  • Adults—At first, 0.25 to 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 4 mg per day.
  • Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.
  • Children—Use and dose must be determined by your doctor.

For panic disorder:

For oral dosage form (extended-release tablets):

  • Adults—At first, 0.5 to 1 milligram (mg) taken in the morning once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.
  • Older adults—At first, 0.5 mg taken in the morning once a day. Your doctor may increase your dose as needed.
  • Children—Use and dose must be determined by your doctor.

For oral dosage forms (solution, tablets, or orally disintegrating tablets):

  • Adults—At first, 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.
  • Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.
  • Children—Use and dose must be determined by your doctor.

Modifications

A person 65 years of age or older may be more sensitive to the sedative side effects of Xanax. This means a person may feel extra drowsy while taking Xanax, which could lead to more accidental falls. Dosing may need to be lowered if side effects occur at the recommended starting dose. 

Dosing in older patients with advanced liver disease or debilitating disease should be modified. The usual starting dose is 0.25 mg, given two or three times a day. This can be gradually increased if needed.

Missed Dose

If you miss a dose of alprazolam, you should take the missed dose as soon as you remember. But if it is almost time for the next scheduled dose, you should skip the dose you missed. Do not take extra to make up for the missed dose. Doing so can increase your risk for side effects.

Overdose: What Happens If I Take Too Much Xanax?

Symptoms of an overdose of Xanax include:

  • Impaired coordination
  • Confusion
  • Tiredness
  • Decreased reflexes
  • Coma

Death has also occurred as a result of an overdose of Xanax.

What Happens If I Overdose On Xanax?

If you think you or someone else may have overdosed on Xanax, call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Xanax, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not take itraconazole (Sporanox®) or ketoconazole (Nizoral®) while you are using this medicine. Using any of them together with this medicine may increase the chance of serious side effects.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or seizure medicines, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop using this medicine. Check with your doctor before taking any of the above while you are using this medicine.

If you develop any unusual and strange thoughts or behavior while you are taking alprazolam, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

Alprazolam may cause some people, especially older persons, to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy, or are not alert or able to see well.

Do not change your dose or stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms including changes in behavior, discouragement, feeling sad or empty, irritability, lack of appetite, loss of interest or pleasure, nausea or vomiting, seeing or hearing things that others do not see or hear, seizures or tremors, stomach or muscle cramps, sweating, thoughts of killing oneself, trouble concentrating, trouble sleeping, unusual movements, responses, or expressions.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Symptoms of an overdose include: change in consciousness, confusion, drowsiness, lack of coordination, loss of consciousness, or sleepiness. Call your doctor right away if you notice these symptoms.

Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Xanax?

There are a few reasons why your healthcare provider may not choose Xanax as part of your treatment plan.

Allergies

A person should not take Xanax if they are allergic to alprazolam or other benzodiazepines.

Alcohol

Xanax can increase the effects of alcohol. Therefore, a person should not drink while taking alprazolam.

Pregnancy

Research has shown that Xanax may potentially cause harm to the fetus when taken during pregnancy. Therefore, this drug is not recommended for use during pregnancy.

Talk to your healthcare provider if you are pregnant or plan to become pregnant.

Breastfeeding

Xanax may pass in human breast milk. Generally, a person who is breastfeeding should not use Xanax.

Children

Alprazolam has not been studied in children. It should not be used in a person younger than 18 years old.

Other Health Conditions

The body may handle Xanax differently in people with certain health conditions. 

Inform your healthcare provider if you have:

  • Depression
  • Acute narrow-angle glaucoma
  • History of drug abuse, alcohol abuse, or personality disorder
  • Liver disease
  • Obesity
  • Lung disease

What Other Medications Interact With Xanax?

Before taking Xanax, be sure to tell your healthcare provider about all of the prescription medications, over-the-counter medications, vitamins, supplements, and herbs you are taking. This will help you avoid potential interactions.

Certain medications may interact with Xanax when used together. Some of these medications can cause harmful effects, increase the risk of side effects, or reduce the effectiveness of Xanax.

Should Not Use

Certain drugs can cause dangerous effects in the body when used with Xanax.

These medications are contraindicated with the use of Xanax, meaning they should not be used together:

  • Itraconazole or ketoconazole: When used with Xanax, these antifungal drugs can cause increased drowsiness.
  • Opioids, such as oxycodone or hydrocodone: The FDA issued a boxed warning about opioid use with Xanax. Taking Xanax with an opioid increases your risk for respiratory depression, coma, and even death.

Increased Risk of Side Effects

When taking certain medications with Xanax, you may experience increased drowsiness.

A few examples of those medications include:

  • Birth control pills
  • Antacids (e.g., cimetidine)
  • Barbiturates (e.g., phenobarbital, butabarbital)
  • Sedatives (e.g., zolpidem)
  • Sedative antihistamines (e.g., diphenhydramine, chlorpheniramine)
  • Anesthetics (e.g., propofol, ketamine)
  • Antidepressants (e.g., fluoxetine)

Less Effective

When taken with Xanax, anticonvulsant drugs, including carbamazepine and phenytoin, can decrease the effectiveness of the medication. Additionally, cigarette smoking can reduce Xanax blood concentrations and therefore make it less effective.

What Medications Are Similar?


Other commonly prescribed benzodiazepines include:

  • Klonopin (clonazepam)
  • Valium (diazepam)
  • Ativan (lorazepam)

Klonopin 

Klonopin is used to treat panic disorders and seizures. It is available as an oral tablet and an orally disintegrating tablet.

Valium

Valium is used to treat anxiety and symptoms caused by alcohol withdrawal. It also can be used as an add-on treatment for muscle spasms and certain types of seizures. Valium is available as an oral tablet, an intravenous injection, an oral solution, a nasal spray, and a rectal gel.

Ativan 

Ativan is used to treat anxiety, insomnia, sleep before surgery, and certain types of seizures. It is available as an oral tablet or intravenous

Even though all of these medications are from the same class (benzodiazepines), they have a variety of uses and forms. 

This is a list of drugs from the same class of medication as Xanax. It is not a list of drugs recommended to take with Xanax. Ask your pharmacist or healthcare provider if you have any questions.

Frequently Asked Questions

  • What is Xanax used for?

    Xanax is a benzodiazepine. It works on specific receptors in your brain, helping to boost the activity of a certain chemical that helps create a calming effect. Xanax is often prescribed to treat anxiety and panic disorders.

  • How do I safely stop taking Xanax?

    You should not stop taking Xanax abruptly without speaking with your healthcare provider. Doing this can cause withdrawal symptoms, such as tremors, hallucinations, or feeling restless. Instead, to help prevent withdrawal symptoms, your provider will gradually reduce your dose of Xanax over time.

How Can I Stay Healthy While Taking Xanax?

Xanax is a safe and effective medication when used correctly. The medication helps with short-term relief of anxiety symptoms and treats panic disorders.

Although side effects can occur, they tend to happen at the beginning of treatment and get better with time. Your healthcare provider will typically start you with a low dose and slowly increase it until you find the optimal dose. This will also help with decreasing the risk of side effects.

It is important to inform your healthcare provider of all of your other health conditions and any prescription medications, over-the-counter medications, vitamins, supplements, and herbs you are taking.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Food and Drug Administration. Xanax XR tablets. Updated September 2016.

  3. Daily Med. ALPRAZOLAM tablet, orally disintegrating. Updated January 2021.

  4. Daily Med. ALPRAZOLAM solution, concentrate. Updated February 2017.

  5. Daily Med. XANAX XR- alprazolam tablet, extended release. Updated March 12, 2021.

  6. Food and Drug Administration. Klonopin (clonazepam) tablets. Updated October 2017.

  7. Food and Drug Administration. Valium (diazepam) tablets. Updated January 2008.

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