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Side effects of Xanax
Side effects are often observed at the beginning of therapy and usually disappear upon continued use of medication. Possible side effects of Xanax include:4,6
- Low energy
- Impaired coordination
- Memory impairment
- Abnormal involuntary movement
- Decreased libido
- Confusional state
- Muscle twitching
- Muscle cramps
- Increased libido
- Dry mouth
- Increased salivation
- Inflammation of skin caused by allergy
- Chest pain
- Nasal congestion
- Blurred vision
- Menstrual disorders
- Upper respiratory infection
- Dream abnormalities
- Increased appetite
- Weight gain
- Decreased appetite
- Weight loss
- Slurred speech
Xanax may cause drowsiness, dizziness, light-headedness or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Xanax.
The above is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. Side effects can be reported to the FDA at 1-800-FDA-1088.
Seek emergency medical help if you have any of these signs of an allergic reaction to Xanax: hives, difficulty breathing, and swelling of your face, lips, tongue or throat.5
Call your doctor at once if you have a serious side effect such as:
- Depressed mood, thoughts of suicide or hurting yourself, unusual risk-taking behavior, decreased inhibitions, no fear of danger
- Confusion, hyperactivity, agitation, hostility, hallucinations
- Feeling like you might pass out
- Urinating less than usual or not at all
- Chest pain, pounding heartbeats or fluttering in your chest
- Uncontrolled muscle movements, tremor, seizure (convulsions)
- Jaundice (yellowing of the skin or eyes).
How to use Xanax
Alprazolam comes as a tablet, an extended-release tablet, an orally disintegrating tablet (tablet that dissolves quickly in the mouth), and a concentrated solution (liquid) to take by mouth.11
Xanax should be taken by mouth as directed by your doctor. Dosage is based on the following factors:2
- Medical condition
- Response to treatment.
Dosage of Xanax may be increased gradually until the drug works effectively for the patient. The instructions of a doctor should be closely followed to reduce the risk of side effects.
If this medication has regularly been used for a long time or in high doses, withdrawal symptoms (such as seizures) can occur if usage is suddenly stopped. To prevent these reactions, the doctor may reduce the dosage of Xanax gradually.
Xanax are available in doses of:
- 0.25 mg - white, oval, scored, imprinted "XANAX 0.25"
- 0.5 mg - peach, oval, scored, imprinted "XANAX 0.5"
- 1 mg - blue, oval, scored, imprinted "XANAX 1.0"
- 2 mg - white, oblong, multi-scored, imprinted "XANAX" on one side and "2" on the reverse side.
Do not crush, chew or break a Xanax extended-release tablet. Swallow the tablet whole. It is specially made to release medicine slowly in the body. Breaking the tablet would cause too much of the drug to be released at one time.5
Do not share your medicine with other people. It may not be suitable for them and may harm them.
What happens if I miss a dose?
If you miss a dose of Xanax, 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.5
What happens if I overdose?
Manifestations of an alprazolam overdose include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Death has been reported in association with overdoses of alprazolam by itself, as it has with other benzodiazepines.4
If an overdose of Xanax occurs, call your doctor or 911. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.5
Xanax should be stored at controlled room temperature 20° to 25°C.
Changes in the absorption, distribution, metabolism and excretion of benzodiazepines have been reported in a variety of states and populations such as:4
- Alcoholic liver disease
- Impaired hepatic function
- Impaired renal function
- Elderly patients
- Obese patients.
Do not use Xanax if you are allergic to alprazolam or other benzodiazepines such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).5
Do not drink alcohol while taking Xanax. Xanax can increase the effects of alcohol.5
Xanax is in FDA pregnancy category D. Do not use Xanax if you are pregnant. Benzodiazepines can potentially cause fetal harm when administered to pregnant women. Xanax is assumed to be like other members of the benzodiazepine class and are capable of causing an increased risk of congenital abnormalities when administered to a pregnant woman during the first trimester.
Benzodiazepines, including Xanax, can potentially cause fetal harm when administered to pregnant women.
Use of Xanax during the first trimester of pregnancy should usually be avoided.
Patients should be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physicians about the desirability of discontinuing the drug.4
The child born of a mother who is receiving benzodiazepines may be at some risk for withdrawal symptoms from the drug during the postnatal period. Also, respiratory problems have been reported in children born to mothers who have been receiving benzodiazepines.4
Due alprazolam's similarity to other benzodiazepines, it is assumed that Xanax undergoes transplacental passage and that it is excreted in human milk.4
Chronic administration of diazepam (another benzodiazepine) to nursing mothers has been reported to cause their infants to become lethargic and to lose weight. As a general rule, mothers who must use Xanax should not undertake nursing.4
Alprazolam has not been studied in pediatric patients.4 Safety and effectiveness of Xanax in individuals below 18 years of age has not been established.
Gender has no effect on pharmacokinetics (the process by which a drug is absorbed, distributed, metabolized and eliminated by the body) of alprazolam.4
The elderly may be more sensitive to the effects of benzodiazepines. They exhibit higher plasma alprazolam concentrations due to reduced clearance of the drug as compared with a younger population receiving the same doses.4
The sedative effects of Xanax 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 Xanax.5
Maximal concentrations (the peak concentration that a drug achieves in a specified compartment after the drug has been administrated and before administration of a second dose) and half-life (the time required for the concentration of the drug to reach half of its original value) are approximately 15% and 25% higher in Asian populations compared with white populations.4
Alprazolam concentrations may be reduced up to 50% in smokers compared to non-smokers.4
As with other psychotropic medications, the usual precautions with respect to administration of the drug and size of the prescription are indicated for severely depressed patients or those in whom there is reason to expect concealed suicidal ideation or plans. Panic disorder has been associated with primary and secondary major depressive disorders and increased reports of suicide among untreated patients.4
Episodes of hypomania and mania have been reported in association with the use of Xanax in patients with depression.4
Uricosuric effect (promoting the excretion of uric acid in the urine)
Alprazolam has a weak uricosuric effect. Although other medications with weak uricosuric effect have been reported to cause acute renal failure, there have been no reported instances of acute renal failure attributable to therapy with Xanax.
On the next page, we look at drug interactions and information on dependence and withdrawal from Xanax.