This drug has a box warning. This is the most serious warning from the Food and Drug Administration (FDA). A
- Taking alprazolam with opioid drugs increases a person’s risk of severe sleepiness, respiratory depression, coma, and even death. People should not take alprazolam with an opioid unless there are no other available treatment options.
- Using alprazolam, even as prescribed, can lead to physical dependence and withdrawal if a person stops taking the drug suddenly. Withdrawal can be life threatening.
- Taking this drug can also lead to misuse and addiction. Misuse of alprazolam increases the risk of overdose and death.
- A person should only take this drug as their doctor prescribes. People can talk with a healthcare provider if they have any concerns about safely taking this drug.
Alprazolam (Xanax) concentration peaks in the bloodstream 1–2 hours after consumption. Typically, the body eliminates half of the drug after 11 hours, but this varies between people.
Doctors often prescribe Xanax to treat acute episodes of generalized anxiety disorder and panic disorder. It is
Xanax works by increasing the effects of gamma-aminobutyric acid in the brain. This is a neurotransmitter that increases feelings of calmness.
This article discusses how long the effects of Xanax last, the timeline for withdrawal, and the various factors that affect this timing. It also describes when Xanax expires and how to safely dispose of old medication.
As with many drugs, Xanax stays in the body long after a person stops feeling its effects. Experts use a half-life measurement to determine how long a drug stays in the body. A drug’s half-life is the time it takes the body to eliminate half of it.
The half-life of Xanax is
However, the term “half-life” can be misleading. This is because it takes four to five half-lives for the body to eliminate a drug. This means that it may take an average of 44–55 hours, or about 2 days, for Xanax to leave the body.
In one 2019 study, researchers reported that they could detect Xanax in a person’s saliva for up to 2.5 days after their last dose.
The body absorbs Xanax quickly after a person takes it. Peak levels in the blood occur 1–2 hours after taking a dose. However, the person will feel the effects before levels peak, usually within 1 hour.
The half-life of Xanax can vary from person to person. Several factors can affect how quickly the body processes it.
Some factors that may affect the half-life of Xanax include:
- being an older adult
- being of Asian descent
- smoking
- having obesity
- having alcohol use disorder
- having kidney problems
- having liver problems
These factors can increase the time it takes for the body to eliminate Xanax.
Which drugs can interfere with processing Xanax?
Taking a CY3PA inhibitor with Xanax means the body will take longer to process the drug. This can cause Xanax to build up in the blood and increase the risk of serious side effects.
The following are some examples of CYP3A inhibitors:
- birth control pills
- azole antifungal agents, including ketoconazole and itraconazole
- cimetidine, which reduces stomach acid and treats digestive issues
- antidepressants such as fluvoxamine and nefazodone
It is possible that Xanax could interact with some other medications and substances, including:
- diltiazem
- isoniazid
- macrolide antibiotics, such as erythromycin and clarithromycin
Xanax and opioids
Opioids are prescription pain relievers that block pain signals in the brain. Xanax can interact with opioids, and the interactions can be severe. The risk of severe adverse effects is high in both prescription opioids and nonprescription opioids, such as heroin.
Prescription opioids include:
Taking Xanax and opioids together can cause a fatal overdose, in addition to severe interactions. This is because both opioids and Xanax slow a person’s breathing, and combining them may cause breathing to stop altogether.
If a person has been taking an opioid pain reliever, they should talk with a healthcare professional before taking Xanax. Likewise, anyone taking Xanax should speak with a doctor before taking an opioid.
When a person stops taking Xanax after their body has become used to receiving it, the lack of the drug can cause a range of physical and mental symptoms. These are called withdrawal symptoms.
Withdrawal symptoms for short-acting benzodiazepines such as Xanax
Xanax withdrawal can be dangerous. Symptoms of withdrawal include:
- headaches
- sweating
- sensitivity to light or sound
- muscle twitching
- muscle cramps
- insomnia and other sleep issues
- blurred vision
- diarrhea
- difficulty concentrating
- panic attacks
- anxiety
- seizure
A doctor can help a person gradually reduce their Xanax dosage. This is known as tapering. Tapering can minimize the risk of serious withdrawal symptoms, including seizures.
A bottle of Xanax should carry an expiration date and the date that the pharmacist filled the prescription.
Expiration dates indicate how long the drug is safe and effective to take. This depends on when the manufacturer made the drug.
Disposing of expired Xanax
As Xanax carries a high risk of dependency, it is important to dispose of expired or unwanted pills correctly.
In the United States, correct disposal means taking the medication to an authorized Drug Enforcement Administration (DEA) controlled substances disposal location. A person can find a local location using the DEA’s online system. There are also drug take-back days at select times of the year.
Xanax can be an effective treatment for short-term anxiety and panic attacks if a person follows their doctor’s guidance.
Factors such as other medications and certain health conditions can affect how Xanax works and how long it stays in the body.
Anyone with an anxiety or panic disorder should work with a healthcare professional to develop a safe and effective treatment program.