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Generic Name: alprazolam (al PRAY zoe lam)
Brand Name: Niravam, Xanax, Xanax XR

What is alprazolam?

Alprazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). Alprazolam affects chemicals in the brain that may be unbalanced in people with anxiety.

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

Alprazolam may also be used for purposes not listed in this medication guide.

What is the most important information I should know about alprazolam?

You should not use this medicine if you have narrow-angle glaucoma, if you also take itraconazole or ketoconazole, or if you are allergic to alprazolam or similar medicines (Valium, Ativan, Tranxene, and others).

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

Alprazolam may be habit-forming. Misuse of habit-forming medicine can cause addiction, overdose, or death.

What should I discuss with my healthcare provider before taking alprazolam?

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

You should not take alprazolam if you have:

  • narrow-angle glaucoma;

  • if you are also taking itraconazole or ketoconazole; or

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

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

  • seizures or epilepsy;

  • liver or kidney disease;

  • asthma or other breathing disorder;

  • open-angle glaucoma;

  • kidney or liver disease (especially alcoholic liver disease);

  • a history of depression or suicidal thoughts or behavior; or

  • a history of drug or alcohol addiction.

Do not use alprazolam if you are pregnant. This medicine can cause birth defects. Your baby could also become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant. Use effective birth control to prevent pregnancy while you are taking alprazolam.

Alprazolam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using alprazolam.

The sedative effects of alprazolam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking alprazolam.

Alprazolam is not approved for use by anyone younger than 18 years old.

How should I take alprazolam?

Follow all directions on your prescription label. Never use alprazolam in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in treating your symptoms.

Alprazolam may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Misuse of habit-forming medicine can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.

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

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

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

Do not stop using alprazolam suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using alprazolam.

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

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Alprazolam is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of alprazolam can be fatal. Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, loss of balance or coordination, feeling light-headed, and fainting.

What should I avoid while taking alprazolam?

Alprazolam may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol with this medicine can cause side effects.

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

Alprazolam side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • depressed mood, thoughts of suicide or hurting yourself;

  • racing thoughts, increased energy, unusual risk-taking behavior;

  • confusion, agitation, hostility, hallucinations;

  • uncontrolled muscle movements, tremor, seizure (convulsions); or

  • pounding heartbeats or fluttering in your chest.

Common side effects may include:

  • drowsiness, feeling tired;

  • slurred speech, lack of balance or coordination;

  • memory problems; or

  • feeling anxious early in the morning.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect alprazolam?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking alprazolam with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

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

  • cimetidine;

  • digoxin;

  • fluvoxamine;

  • nefazodone;

  • ritonavir or other medicines to treat HIV or AIDS; or

  • antifungal medicine--fluconazole, voriconazole.

This list is not complete. Other drugs may interact with alprazolam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about alprazolam.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 10.02. Revision Date: 2015-09-24, 2:17:25 PM.