Alprazolam is the generic version of Xanax. As a benzodiazepine, alprazolam calms anxiety and panic disorder by slowing down the nervous system. The downside is that its use can lead to dependence and addiction, so healthcare professionals are cautious to use it only for short-term treatment and only when necessary.
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Xanax, Xanax XR
Alprazolam
Treats anxiety and panic disorder
Anxiolytic, benzodiazepine
Tablet, orally dissolving tablet, extended-release tablet, oral solution
By mouth
Alprazolam is FDA-approved to treat acute episodes of generalized anxiety disorder (GAD) and to treat panic disorder.
Alprazolam is used to treat anxiety or panic for short periods of time, and usually with other anxiety medications or therapy.
There are other medications and treatments that are more effective and safer than alprazolam to treat anxiety and panic disorder in the long term.
Alprazolam can be dangerous when combined with alcohol, opioids, and other medications that cause sedation.
Taking alprazolam and other benzodiazepines comes with a risk of misuse and addiction.
Alprazolam and other benzodiazepines can cause physical dependence. When they are taken for longer periods of time or at higher doses, they should not be stopped suddenly because of the risk of withdrawal symptoms.
Tablet
0.25 mg
0.5 mg
1 mg
2 mg
Orally disintegrating tablet
0.25 mg
0.5 mg
1 mg
2 mg
Extended-release tablet
0.5 mg
1 mg
2 mg
3 mg
Oral solution
1 mg/mL
For generalized anxiety disorder: 0.25–0.5 mg immediate-release alprazolam three times per day. The dose may be increased by a healthcare provider every 3 to 4 days if needed. Maximum total daily dose: 4 mg/day
For panic disorder: 0.5 mg immediate-release alprazolam three times per day OR 0.5-1 mg extended-release tablets taken once per day. The dose may be increased by a healthcare provider every 3 to 4 days if needed. Maximum total daily dose: 6-10 mg/day.
RELATED: Xanax dosage, forms, and strengths
ALPRAZolam
0.25mg tablet
ALPRAZolam
0.5mg tablet
ALPRAZolam
1mg tablet
ALPRAZolam
2mg tablet
ALPRAZolam
0.25mg tablet disintegrating
ALPRAZolam
0.5mg tablet disintegrating
ALPRAZolam
1mg tablet disintegrating
ALPRAZolam
2mg tablet disintegrating
Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
Read the medication guide before taking this medicine.
Make sure to read the section titled, “What is the most important information I should know about alprazolam.”
How to take alprazolam tablets:
Swallow tablets whole with a glass of water. Do not crush, break, or chew the tablets.
Store alprazolam tablets in a closed container at room temperature, out of the reach of children.
How to take alprazolam orally disintegrating tablets:
Only remove a tablet from the bottle when ready to take a dose.
Dry your hands before removing the tablet.
Carefully remove the tablet from the bottle.
Immediately place the tablet on your tongue and let it dissolve before swallowing.
Remove the cotton from the bottle after the first use.
Store alprazolam ODT in a tightly closed container at room temperature protected from moisture.
How to use alprazolam oral solution:
Alprazolam oral solution is highly concentrated.
Only use the dosing syringe that comes with the medicine to measure out a dose. Never use tableware or kitchen measuring devices.
Doses are written on the calibrated oral syringe starting at 0.25 mg.
You do not need to shake the bottle before measuring out a dose.
Store alprazolam oral solution in a tightly closed container at room temperature
Throw away the bottle and any remaining medicine 90 days after opening it.
Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose.
Do not take extra medicine to make up for a missed dose.
This medicine is not right for everyone.
Do not use it if you have had an allergic reaction to alprazolam or other benzodiazepines such as Valium (diazepam).
Tell your healthcare provider about all medications and health conditions.
Your healthcare provider will schedule regular appointments to check the effects of this medicine. Keep all appointments.
Tell your healthcare provider if you have:
Kidney disease
Liver disease
Lung disease
Breathing problems
A history of seizures
A history of mental health issues such as depression, mood problems, or suicidal thoughts or behaviors
A history of drug or alcohol abuse or dependency
Alprazolam use can lead to physical dependency and cause serious withdrawal symptoms when discontinued.
Never increase the dose or take it more often than instructed. Call your healthcare provider if you think your medicine is not working.
Taking too much alprazolam can cause serious side effects and significant impairment.
Alprazolam abuse can lead to overdose or death.
Alprazolam may not be safe to take long term. Long-term use can lead to physical dependency and result in protracted withdrawal symptoms.
Do not stop using this medicine suddenly.
Your healthcare provider will need to slowly decrease your dose before you stop it completely.
Alprazolam is a federally controlled substance. Giving or selling this drug to anyone else is dangerous and against the law.
Do not take alprazolam when pregnant. Tell your healthcare provider right away if you become pregnant. Alprazolam could harm an unborn baby.
Tell the healthcare provider if you’re breastfeeding or planning to breastfeed. Alprazolam can make a nursing infant sleepy or less willing to feed.
This medicine can increase thoughts of suicide. Tell your healthcare provider right away if you start to feel depressed and have thoughts about hurting yourself.
This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Because of the risk of overdose, death, or misuse, keep alprazolam securely out of the reach of children.
To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you are using before taking alprazolam.
Tell other healthcare providers you are using this medicine before they prescribe new medications.
Some drugs can be dangerous to take with alprazolam:
Never take alprazolam along with the antifungal drugs ketoconazole or itraconazole.
Combining alprazolam with opioids can cause slowed breathing, coma, and death.
Combining alprazolam with other sedatives will worsen sedation and impairment. These include other benzodiazepines, antihistamines, sleeping pills, and muscle relaxants.
Do not drink alcohol when taking alprazolam.
Avoid eating grapefruit or drinking grapefruit juice when taking alprazolam.
Tell the prescribing healthcare provider if you are using any of the following medicines:
Mental health medications such as SSRIs
Antifungal drugs called azoles
Birth control pills
Macrolide antibiotics such as clarithromycin or erythromycin
Nefazodone, fluvoxamine, cimetidine, digoxin
Find more detailed information about alprazolam interactions to avoid here.
Serious side effects
Talk to a healthcare provider if you notice any signs or symptoms of a possible serious side effect, including:
Blue lips, fingernails, or skin
Extreme drowsiness or weakness, slow heartbeat, trouble breathing
Seizures
Fast heart rate
Severe skin rash or redness
Signs of liver problems such as nausea, abdominal pain or fullness, or a yellowing of the skin or eyes
Confusion, lightheadedness, dizziness, problems with muscle control or coordination
Unusual mood or behavior, worsening depression, thoughts about hurting yourself, trouble sleeping
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Less serious side effects
Drowsiness
Tiredness
Mild loss of coordination
Irritability
Memory problems
Appetite changes
Trouble thinking or concentrating
Weight changes
Constipation
Lowered sex drive
Dry mouth
Slow or thick speech
Mild confusion or forgetfulness
Find more detailed information about Xanax (alprazolam) side effects here.
Alprazolam orally disintegrating tablet prescribing information, DailyMed (NIH National Library of Medicine)
Alprazolam solution, concentrate prescribing information, DailyMed (NIH National Library of Medicine)
Alprazolam tablet prescribing information, DailyMed (NIH National Library of Medicine)
Xanax alprazolam tablet prescribing information, DailyMed (NIH National Library of Medicine)
Xanax XR alprazolam extended-release tablet prescribing information, DailyMed (NIH National Library of Medicine)
Anne Jacobson, MD, MPH, is a board-certified family physician, writer, editor, teacher, and consultant. She is a graduate of University of Wisconsin School of Medicine and Public Health, and trained at West Suburban Family Medicine in Oak Park, Illinois. She later completed a fellowship in community medicine at PCC Community Wellness and a master's in Public Health at the University of Illinois-Chicago. She lives with her family near Chicago.
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