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Is it safe to mix Xanax with coffee?

These two substances can cancel each other out—and even worsen symptoms

Xanax (alprazolam) is part of the benzodiazepines class of drugs. These types of drugs work by slowing down the brain and central nervous system (CNS), helping you to feel relaxed. Xanax is prescribed to treat anxiety and panic disorders. One of the side effects of Xanax is drowsiness. If you are feeling tired after taking  Xanax, you may have reached for a cup of coffee to help you feel more awake. But mixing Xanax and caffeine is not a good idea. Here’s what you need to know about drinking your morning joe if you’ve taken this medication.

The best time to take Xanax

Xanax starts to work within one to two hours after taking it and lasts for about five hours. The extended-release version can last for up to 11 hours on average. If you are taking extended-release Xanax, the best time to take it is in the morning, just when you would want to have some caffeine to wake up.

“Benzodiazepines are widely prescribed for as-needed use, for this reason it comes down to if you are more anxious at night or in the morning,” says Joseph Kennedy, Pharm.D., a pharmacist at CVS in Troy, New York. Xanax is typically only prescribed for a limited time since you could become dependent on it or build up a tolerance for it.

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Is it safe to take Xanax and coffee together?

If you take Xanax and like to drink coffee, you may want to switch to decaf. 

“Coffee contains caffeine, essentially another drug that has the opposite effects of Xanax,” says Dr. Kennedy. Caffeine is a stimulant that speeds up your central nervous system. It can help you to feel more awake, but it can also cause an increased heart rate and insomnia. 

Xanax is a depressant that slows down your central nervous system. It can help you to feel relaxed, but when you take it with caffeine, the medication may not work. “Drinking coffee can nullify the effects,” says Bradley J Katz, MD, Ph.D., a professor and neuro-ophthalmologist at the University of Utah Medical Center.

How coffee affects anxiety or panic disorders

You may like the energy boost that drinking coffee provides, but too much caffeine can make you feel fidgety and increase your heart rate.  When you experience anxiety or a panic disorder, you might also have an increased heart rate. 

“Caffeine may aggravate symptoms in persons who are already anxious,” says Linda Khoshaba, NMD, an endocrinologist in Scottsdale, Arizona. A research study showed that people who had anxiety and drank caffeine experienced nervousness, fear, nausea, palpitations, restlessness, and tremors more than those who did not have an anxiety diagnosis.

People who have experienced panic attacks may mistake the increased heart rate from drinking coffee as a sign that they are having a panic attack. This might trigger a panic attack even though the increased heart rate is caused by the caffeine. 

“Caffeine can set off a chain reaction of symptoms in persons predisposed to anxiety disorders, such as sweaty palms, a racing heart, and ringing in the ears, which can escalate to a full-fledged panic attack,” says Rupen Garg, MD, a resident at Albert Einstein College of Medicine.

How to take Xanax or alprazolam safely

“Xanax can make you feel sleepy so avoid driving or operating heavy machinery after you take it,” Dr. Katz says. Xanax can potentially be addictive. You should only use Xanax as prescribed and talk with your doctor about possible side effects and other food or drug interactions. 

What food and drinks should be avoided when taking Xanax?

You can take Xanax with or without food. However, you should avoid eating or drinking grapefruit and grapefruit juice. This citrus affects the liver enzymes that metabolize Xanax.

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This prescription is a controlled substance because sometimes people abuse it and can become dependent on it. You should never mix Xanax with certain medications (especially drugs that also depress the CNS such as sleeping medications, opioids, or muscle relaxants), illegal drugs, or alcohol. The reason these are a bad combination is because there is a high risk of negative side effects such as slow breathing, coma, or death. 

RELATED: 10 drugs you should not mix with alcohol

What vitamins should not be taken with Xanax or alprazolam?

Dr. Katz advises not to take melatonin, St. John’s wort, valerian, dehydroepiandrosterone, or kava with Xanax. These vitamins or supplements affect the nervous system and could have a negative interaction with Xanax. Consult with your doctor before taking any vitamins or supplements with Xanax. 

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