Alprazolam (generic) ~ Xanax registered mark (brand)
Triazolobenzodiazepine anxiolytic (anti-anxiety agent)
Alprazolam is indicated for the treatment of generalized anxiety disorder and for panic disorder, with or without agoraphobia. Alprazolam can also be used for sleep, but may last too long and result in a "hangover."
Important Side Effects
Adverse reactions, if they occur, are usually mild and happen at the beginning of therapy. They generally disappear as the medication is continued or if the dose is lowered. The most frequent side effects reported with alprazolam are drowsiness; dizziness; weakness or tiredness; and unsteadiness. Transient amnesia or memory impairment has been reported with the use of benzodiazepines, but this is usually seen only after higher doses.
This is not a complete list of all known or potential adverse effects. Notify your prescriber or pharmacist of any symptoms that have started since you began taking this medication, changing its dose or adding or changing other medication or diet. Take care when performing any task (such as driving or operating machinery) that requires your attention until you have experience with this drug and are confident you can perform this task safely. The effects of alcohol and other drugs that depress the central nervous system are increased when taking alprazolam. Withdrawal symptoms such as convulsions, tremor, or muscle cramps have occurred after the abrupt withdrawal of alprazolam, although most severe withdrawal symptoms occur in people who have taken large doses over an extended period of time. When stopping alprazolam after extended therapy, the dose must be gradually reduced over time under expert supervision. People who have a history or family history of drug or other substance abuse will be monitored for overuse by their prescriber and pharmacist.
If you are planning to become pregnant, are pregnant or are a nursing mother, the potential benefits of alprazolam must be weighed against the possible hazards. Discuss these issues in advance with all of your health care providers.
Interactions with Other Medications
Alprazolam may produce additive central nervous system depressant effects when taken with other psychotropic medications, anticonvulsants, antihistamines, alcohol or other drugs that depress the CNS. Taking the antidepressants fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox) or nefazodone (Serzone) with alprazolam may increase the effect of alprazolam. Alprazolam increases the plasma concentrations of the tricyclic antidepressants imipramine (Tofranil) and desipramine (Norpramin). Taking alprazolam with propoxyphene (Darvon) may prolong the duration of action of alprazolam. Taking alprazolam with oral contraceptives or antifungal drug such as ketoconazole (Nizoral) may increase the effect and prolong the duration of action of alprazolam. Alprazolam also has increased effects or prolonged duration of action in the presence of other drugs such as diltiazem (Cardizem), isoniazid (Nydrazid), erythromycin (E-Mycin), or grapefruit juice.
This is not a complete list of all known or potential drug interactions. To help prevent problems, always make sure that your pharmacist and all prescribers know about all medications you are taking, including over-the-counter drugs, dietary herbal supplements and folk or home remedies or any unusual foods, drinks or dietary habits.
For anxiety disorder, the usual starting dose is 0.25 mg to 0.5 mg three times daily, to a daily maximum of 4 mg daily. For panic disorder, starting doses are similar to anxiety disorders but may need to be lower in some sensitive patients to avoid unacceptable side effects. The maximum daily dose in panic disorder patients may need to be as high as 10 mg daily in a small percentage of patients. When discontinued after chronic use, the dose should be slowly tapered under expert supervision to avoid possible discomfort, reoccurrence of previous symptoms, or more severe adverse effects.
Alprazolam is available in 0.25 mg, 0.5 mg, 1 mg and 2 mg doses. All tablets are oval and scored, except the 2 mg. The 2 mg tablet is rectangular and triple-scored, which can provide four 0.5 mg segments. The 0.25 mg tablet is white and is imprinted with "Xanax 0.25." The 0.5 mg tablet is peach and imprinted with "Xanax 0.5." The 1 mg tablet is blue and imprinted with "Xanax 1.0." The 2 mg tablet is white and imprinted with "Xanax" on one side and "2" on the other side. Generic versions of alprazolam are available which vary in appearance from manufacturer to manufacturer. Two different strength liquid forms of alprazolam are available as well. Check with your pharmacist if you have questions about identifying any medications you are taking.
Store alprazolam at normal room temperature (68 to 77 degrees F) in a tightly closed, child-, light- and moisture-resistant container. If you have difficulty opening child-resistant containers, your pharmacist can provide you with a container that is easier to open. Keep the medication out of direct sunlight and avoid storing it in a warm and humid area, such as the bathroom or kitchen, to avoid deterioration. To prevent accidental poisoning, keep all medications out of the reach of children or adults with dementia. Do not take an expired medication. Do not transfer medication from one container to another. Carefully discard discontinued medication where children cannot find it.