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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Klonopin (clonazepam) and Xanax (alprazolam) are similar medications used to treat anxiety and panic disorders. Both medications are classified as benzodiazepines, which work by boosting the activity of GABA in the brain. GABA, or gaba-aminobutyric acid, is an inhibitory neurotransmitter that plays a role in slowing down activity in the central nervous system (CNS).
Both Klonopin and Xanax help treat symptoms of anxiety by producing a relaxing and calming effect. However, they have notable differences in how long they work and what they are used for.
What are the main differences between Klonopin and Xanax?
Klonopin
Klonopin is the brand name for clonazepam. It is considered a long-acting benzodiazepine with a half-life of about 30 to 40 hours. Klonopin reaches peak levels in the blood within 1 to 4 hours after taking it.
Klonopin is available as a generic tablet in strengths of 0.5 mg, 1 mg, and 2 mg. Orally disintegrating (ODT) tablets are also available in strengths of 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, and 2 mg.
Xanax
Xanax is commonly known by its generic name alprazolam. Unlike Klonopin, Xanax is a short-acting benzodiazepine with a half-life of around 11 hours. Xanax reaches peak levels in the blood within 1 to 2 hours after administration.
Xanax comes in brand and generic tablets with strengths of 0.25 mg, 0.5 mg, 1 mg, and 2 mg. Extended-release tablets are also available in strengths of 0.5 mg, 1 mg, 2 mg, and 3 mg. Alprazolam can also be prescribed as an ODT tablet or liquid solution (Intensol).
| Main differences between Klonopin and Xanax | ||
|---|---|---|
| Klonopin | Xanax | |
| Drug class | Benzodiazepine Long-acting |
Benzodiazepine Short-acting |
| Brand/generic status | Brand and generic version available | Brand and generic version available |
| What is the generic name? | Clonazepam | Alprazolam |
| What form(s) does the drug come in? | Oral tablet Orally disintegrating tablet |
Oral tablet Orally disintegrating tablet Extended-release tablet |
| What is the standard dosage? | Panic Disorder: Initially, 0.25 mg by mouth twice daily. After 3 days, dose may be increased by 0.125 mg to 0.25 mg twice daily every 3 days to a target dose of 1 mg per day. Seizures: 1.5 mg per day divided into 3 doses. Dose may be increased by 0.5 mg to 1 mg every 3 days to a maximum dose of 20 mg per day. |
Panic Disorder: Immediate-release or ODT tablets: 0.5 mg by mouth three times daily. Dose may be increased by up to 1 mg per day every 3 to 4 days to a range of 1 to 10 mg/day. Extended-release tablets: 0.5 mg to 1 mg by mouth once daily. Dose may be increased by up to 1 mg per day every 3 to 4 days to a range of 3 to 6 mg per day. |
| How long is the typical treatment? | Duration of treatment is determined on an individual basis. Long-term use of benzodiazepines is not generally recommended. | Duration of treatment is determined on an individual basis. Long-term use of benzodiazepines is not generally recommended. |
| Who typically uses the medication? | Adults, 18 years of age and older
Children with seizure disorder, up to 10 years of age or 30 kg of body weight |
Adults, 18 years of age and older |
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Conditions treated by Klonopin and Xanax
As anxiolytic medications, Klonopin and Xanax can help relieve symptoms of anxiety and panic attacks. Klonopin and Xanax are both FDA-approved to treat panic disorder in adults with or without agoraphobia.
Klonopin is also approved to treat seizure disorders in adults and children. It is often used alone or in combination with other treatments for Lennox-Gastaut syndrome, atonic seizures, and myoclonic seizures. Klonopin may also be used to treat absence seizures.
Xanax is approved for short-term relief of anxiety disorder symptoms. Anxiety disorders include generalized anxiety disorder and social phobia. According to its FDA label, Xanax can also treat anxiety that is accompanied by depression.
Off-label uses of Klonopin and Xanax include insomnia, essential tremor, premenstrual syndrome, and restless leg syndrome.
| Condition | Klonopin | Xanax |
| Anxiety | Yes | Yes |
| Panic disorder | Yes | Yes |
| Seizure disorder | Yes | No |
| Insomnia | Off-label | Off-label |
| Essential tremor | Off-label | Off-label |
| Restless leg syndrome | Off-label | Off-label |
| Premenstrual syndrome | Off-label | Off-label |
Is Klonopin or Xanax more effective?
Currently, there are no strong head-to-head studies that have compared Klonopin and Xanax. Both benzodiazepines are effective depending on how they’re used and what conditions they are treating.
Klonopin is more effective for treating seizure disorders. It also has a longer duration of action, which means it does not need to be taken as frequently as short-acting benzodiazepines.
Xanax is usually taken multiple times per day to provide relief from anxiety. It lasts for a short duration and may have a higher risk of abuse or misuse than Klonopin.
Since anxiety and depression often occur together, benzodiazepines may be prescribed in combination with an antidepressant. In one meta-analysis, those with general anxiety disorder (GAD) experienced increased benefits when starting on a benzodiazepine and antidepressant together, at least initially.
It’s important to understand that treatment with benzodiazepines is highly individualized. A healthcare provider should be consulted for medical advice on the best treatment option.
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Coverage and cost comparison of Klonopin vs. Xanax
Klonopin is a prescription drug that can be purchased in its generic or brand-name form. Generic Klonopin tablets are usually covered by Medicare and insurance plans. The average retail cost of Klonopin is around $45. Using a prescription discount card can lower the retail price to less than $5
Xanax is also available in generic and brand-name tablets. For immediate-release Xanax tablets, the average retail price can be as high as $62.99. However, with a SingleCare discount card, the out-of-pocket costs can be reduced to $13 at certain pharmacies. The overall cost of your medication will vary based on your preferred pharmacy and how many tablets you are getting.
| Klonopin | Xanax | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare? | Yes | Yes |
| Standard dosage | 1 mg tablets | 1 mg tablets |
| Typical Medicare copay | $0–$24 | $0–$362 |
| SingleCare cost | $5+ | $13-$23 |
Common side effects of Klonopin vs. Xanax
The most common side effects of Klonopin and Xanax include drowsiness and depression. Those who take Klonopin or Xanax can also experience fatigue, dizziness or lightheadedness, loss of coordination, and memory impairment. Dry mouth is another possible side effect associated with Klonopin and Xanax.
Serious side effects of benzodiazepines can include severe drowsiness, confusion, seizures, weakness, and trouble breathing. Serious side effects are more likely to occur with an overdose or when the drug is not taken as prescribed.
| Klonopin | Xanax | |||
| Side effect | Applicable? | Frequency | Applicable? | Frequency |
| Drowsiness | Yes | 37% | Yes | 41% |
| Depression | Yes | 7% | Yes | 14% |
| Dizziness | Yes | 8% | Yes | 2% |
| Fatigue | Yes | 7% | Yes | >1% |
| Loss of coordination | Yes | 5% | Yes | >1% |
| Memory impairment | Yes | 4% | Yes | >1% |
| Dry mouth | Yes | * | Yes | 15% |
*not reported
Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: DailyMed (Klonopin), DailyMed (Xanax)
Drug interactions of Klonopin vs. Xanax
Klonopin and Xanax are primarily metabolized, or processed, in the liver by the CYP3A4 enzyme. CYP3A4 inhibitors can increase blood levels of these benzodiazepines, which can result in increased adverse effects. CYP3A4 inhibitors include antifungals like ketoconazole and antibiotics like erythromycin.
CYP3A4 inducers can speed up the metabolism of Klonopin or Xanax and decrease their effectiveness. CYP3A4 inducers include anticonvulsant drugs like phenytoin and carbamazepine, among others.
Because Klonopin and Xanax have CNS depressant effects, they can interact with other drugs that have similar effects. Taking benzodiazepines with drugs such as opioids and tricyclic antidepressants can increase the risk of severe drowsiness, respiratory depression, and even death, especially in large doses.
| Drug | Drug class | Klonopin | Xanax |
| Ketoconazole Itraconazole Fluvoxamine Erythromycin Nefazodone |
CYP3A4 inhibitors | Yes | Yes |
| Phenytoin Carbamazepine Phenobarbital Lamotrigine |
CYP3A4 inducers | Yes | Yes |
| Hydrocodone Oxycodone Tramadol |
Opioids | Yes | Yes |
| Amitriptyline Nortriptyline Imipramine |
Tricyclic antidepressants | Yes | Yes |
This may not be a complete list of all possible drug interactions. Consult a doctor with all the medications you may be taking.
Warnings of Klonopin and Xanax
Both Klonopin and Xanax have warnings on their drug labels about using benzodiazepines with opioids. The combination of benzodiazepines and opioids can lead to sedation, shallow breathing, coma, and death. For this reason, these drugs should not be taken together. If they must be taken together, their dosages should be monitored or adjusted to ensure safety.
Benzodiazepines—sometimes called “benzos”—are commonly abused. Those who have a history of substance abuse in the past may be at an increased risk of abuse and dependence with benzodiazepines. Klonopin and Xanax are Schedule IV drugs as classified by the DEA in the United States.
Benzodiazepines are intended for short-term use and should not be discontinued abruptly. Stopping these medications without tapering their doses can lead to withdrawal symptoms.
In severe cases, withdrawal symptoms can be life-threatening and include rebound anxiety, insomnia, and seizures. Because of the short-acting nature of Xanax, withdrawal may be more likely to occur with Xanax compared to Klonopin.
Frequently asked questions about Klonopin vs. Xanax
What is Klonopin?
Klonopin is a long-acting benzodiazepine that is FDA-approved to treat panic disorders and seizures. It is available in immediate-release and orally disintegrating tablets. Klonopin can be used for seizure disorders in adults aged 18 years and older as well as children up to 10 years of age.
What is Xanax?
Xanax is a short-acting benzodiazepine that is used to treat anxiety disorders and panic disorders. It comes as an oral tablet, orally disintegrating tablet, extended-release tablet, and oral liquid. Xanax is typically prescribed in adults aged 18 years and older.
Are Klonopin and Xanax the same?
Klonopin and Xanax are not the same. Klonopin lasts longer in the body compared to Xanax. Klonopin can also be used to treat certain types of seizures in adults and children.
Is Klonopin or Xanax better?
Both Klonopin and Xanax are effective treatments for symptoms of anxiety and panic attacks. Klonopin can be taken once or twice daily while Xanax may need to be taken multiple times per day for maximum relief. The risk of abuse, misuse, and dependence may be higher with Xanax than Klonopin. Consult a physician to determine your best treatment option.
Can I use Klonopin or Xanax while pregnant?
Klonopin and Xanax are not generally recommended to be used during pregnancy. There is a possibility that these drugs could cause birth defects. Many medical professionals will recommend avoiding benzodiazepines in women who are pregnant. Check with your doctor for available treatment options while pregnant.
Can I use Klonopin or Xanax with alcohol?
Alcohol can compound the side effects of Klonopin or Xanax and lead to more serious adverse effects if taken together. Drinking alcohol while on Klonopin or Xanax can lead to severe drowsiness, loss of coordination, and respiratory depression. There are many cases of coma and respiratory depression in those who combine alcohol with benzodiazepines.
How does Klonopin make you feel?
Klonopin has anxiolytic effects that can help relax and calm symptoms of anxiety. After taking Klonopin, you may feel more at ease and less scared or stressed. Those who live with constant anxiety may feel more able to go about their daily life without constant worry.
Can Klonopin make you crazy?
Klonopin can help treat mental health disorders. When taken as prescribed, Klonopin can help treat debilitating anxiety, panic disorders, and seizures. However, if you abuse Klonopin or are physically dependent on it, you may be more likely to experience withdrawal symptoms after stopping treatment. Withdrawal symptoms can include changes in behavior such as irritability, mood swings, and agitation. Klonopin should be tapered slowly in order to avoid withdrawal symptoms.
