1. Alprazolam oral tablet is available as a generic drug and as brand-name drugs. Brand names: Alprazolam Intensol, Xanax, and Xanax XR.
  2. Alprazolam oral tablets come in immediate-release and extended-release forms, as well as an orally disintegrating form. Alprazolam also comes as an oral solution.
  3. Alprazolam is used for the short-term treatment of anxiety disorders and panic disorder. Extended-release alprazolam is only used to treat panic disorder.

Alprazolam oral tablet is a prescription drug that’s available as the brand-name drugs Alprazolam Intensol, Xanax, or Xanax XR. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Alprazolam oral tablets come in immediate-release and extended-release forms, as well as an orally disintegrating form. Alprazolam also comes as a solution. All forms are taken by mouth.

An extended-release drug is released slowly into the bloodstream over time. An immediate-release drug is released into the bloodstream more quickly. The extended-release drug is only used to treat panic disorder.

Why it’s used

This drug is used to manage anxiety disorders or panic disorder. It can be used for the short-term relief of symptoms of anxiety or anxiety linked with depression. Anxiety or tension caused by the stress of everyday life usually doesn’t need to be treated with this drug.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

This drug belongs to a class of drugs called benzodiazepines. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug attaches to certain benzodiazepine receptors in your brain and nervous system. This boosts the activity of a chemical called gamma-aminobutyric acid. This helps produce a calming effect in your brain.

Alprazolam can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking alprazolam.

This list does not include all possible side effects.

For more information on the possible side effects of alprazolam, or for tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of alprazolam oral tablets can include:

  • drowsiness
  • dizziness or lightheadedness
  • headache
  • blurred vision
  • memory problems
  • trouble concentrating
  • sleep problems
  • muscle weakness or lack of coordination
  • upset stomach
  • nausea or vomiting
  • diarrhea
  • increased sweating
  • dry mouth
  • stuffy nose
  • weight loss or gain
  • increased or decreased appetite
  • loss of interest in sex

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Mental health issues. Symptoms can include:
    • depressed mood
    • thoughts of suicide
    • confusion
    • hallucinations (seeing or hearing things that aren’t real)
  • Movement problems. Symptoms can include:
    • uncontrolled muscle movements
    • tremor
    • seizures
  • Heart problems. Symptoms can include:
    • chest pain
    • abnormal heartbeat
  • Liver problems. Symptoms can include:
    • jaundice (yellowing of the skin or the whites of the eyes)
  • Urinating less than usual or not at all

The dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using alprazolam to treat
  • your age
  • the form of alprazolam you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended.

However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Dosage for anxiety disorders

Generic: Alprazolam

  • Form: oral immediate-release tablet
  • Strengths: 0.25 milligrams (mg), 0.5 mg, 1 mg, 2 mg
  • Form: orally disintegrating tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg

Brand: Xanax

  • Form: oral immediate-release tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg

Brand: Alprazolam Intensol

  • Form: oral solution
  • Strengths: 1 mg per milliliter (mL)

Adult dosage (ages 18–64 years)

Immediate-release tablet, orally disintegrating tablet, or oral solution:

  • Typical starting dosage: 0.25 mg to 0.5 mg three times daily.
  • Dosage increases: Your doctor may increase your dosage every 3 to 4 days until you reach the dosage that’s best for you.
  • Maximum dosage: 4 mg daily, given in divided doses.
  • Dosage reduction: When you’re stopping treatment, your dosage should be decreased slowly. Your doctor may decrease it by no more than 0.5 mg every 3 days.

Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Immediate-release tablet, orally disintegrating tablet, or oral solution:

  • Typical starting dosage: 0.25 mg, two to three times per day.

Special considerations

  • For people with advanced liver disease: For the immediate-release tablet, the usual starting dosage is 0.25 mg, two or three times daily. Your doctor may gradually increase this dosage if needed.

Dosage for panic disorder

Generic: Alprazolam

  • Form: oral immediate-release tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg
  • Form: orally disintegrating tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg

Generic: Alprazolam XR

  • Form: oral extended-release tablet
  • Strengths: 0.5 mg, 1 mg, 2 mg, 3 mg

Brand: Xanax

  • Form: oral immediate-release tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg

Brand: Xanax XR

  • Form: oral extended-release tablet
  • Strengths: 0.5 mg, 1 mg, 2 mg, 3 mg

Brand: Alprazolam Intensol

  • Form: oral solution
  • Strengths: 1 mg/mL

Adult dosage (ages 18–64 years)

Immediate-release tablet, orally disintegrating tablet, or oral solution:

  • Typical starting dosage: 0.5 mg three times daily.
  • Dosage increases: Your doctor may increase your dosage every 3 to 4 days in amounts of no more than 1 mg per day.
  • Maximum dosage: 10 mg daily, in divided doses.
  • Dosage reduction: When you’re stopping treatment, your dosage should be decreased slowly. Your doctor may decrease it by no more than 0.5 mg every 3 days.

Extended-release tablet:

  • Typical starting dosage: 0.5 mg to 1 mg once per day.
  • Dosage increases: Your doctor may increase your dosage every 3 to 4 days until you reach the dosage that’s best for you.
  • Maximum dosage: 10 mg per day.
  • Dosage reduction: When you’re stopping treatment, your dosage should be decreased slowly. Your doctor may decrease it by no more than 0.5 mg every 3 days.

Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Immediate-release tablet, orally disintegrating tablet, or oral solution:

  • Typical starting dosage: 0.25 mg, two to three times per day.

Extended-release tablet:

  • Typical starting dosage: 0.5 mg once per day.

Special considerations

  • For people with advanced liver disease: For the immediate-release tablet, the usual starting dosage is 0.25 mg, two or three times daily. Your doctor may gradually increase this dosage if needed.

This drug is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: If you stop taking the drug suddenly, you may have significant withdrawal symptoms. These can include life threatening symptoms, such as seizures. To avoid withdrawal, your doctor will decrease your dosage slowly over time. If you don’t take this drug at all, your symptoms may not improve.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. You may have withdrawal symptoms if you don’t take the drug on schedule.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • drowsiness
  • confusion
  • poor coordination
  • slow reflexes
  • coma

If you think you’ve taken too much of this drug, call your doctor or local Poison Control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You should have decreased symptoms of anxiety or a decrease in panic attacks.

This drug comes with several warnings.

FDA warning: Drug interaction with opioids

  • This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
  • Taking alprazolam with opioid drugs increases your risk for severe sleepiness, respiratory depression, coma, and even death. Alprazolam shouldn’t be taken with an opioid unless there are no other available treatment options.
  • Using alprazolam, even as prescribed, can lead to physical dependence and withdrawal if you stop taking the drug suddenly. Withdrawal can be life threatening.
  • Taking this drug can also lead to misuse and addiction. Misuse of alprazolam increases your risk for overdose and death.
  • Only take this drug as your doctor prescribes. Talk with your healthcare provider if you have any concerns about safely taking this drug.
  • Contact your prescriber if you feel dizzy, feel like passing out, or have trouble breathing.

Drug abuse and dependence

Even when used as recommended, alprazolam may cause emotional or physical dependence (addiction). Don’t increase your dosage of this medication without talking to your doctor, even if you think it’s not working.

Also, don’t stop taking this medication suddenly or decrease the dosage without talking to your doctor. This can cause withdrawal symptoms. Some of these can be life threatening, such as seizures. The risk of dependence is increased if you take higher dosages or take this drug for a longer length of time.

Depression and suicidal thoughts

If you have preexisting depression, alprazolam may make your condition worse. If your depression gets worse or you have suicidal thoughts, call your doctor right away.

Allergies

This drug may cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local Poison Control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room. Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction

Alprazolam can cause drowsiness, dizziness, or lightheadedness. Consuming beverages that contain alcohol can increase your risk for these side effects. Try to avoid drinking alcohol while taking this drug.

Warnings for people with certain health conditions

For people with depression: If you have preexisting depression, this drug may make your condition worse. If your depression gets worse or you have suicidal thoughts, call your doctor right away.

For people with acute narrow-angle glaucoma: This drug can make your condition worse. Don’t take this drug if you have acute narrow-angle glaucoma.

For people with a history of alcohol abuse disorder, drug abuse, or personality disorder: This drug can lead to physical and psychological dependence (addiction). If you have a history of these conditions, you have a greater risk for dependence on this drug.

For people with liver disease: It may be harder for your body to break down this drug. This can increase the amount of the drug in your body, which can lead to more side effects.

For people with obesity: It may be harder for your body to break down this drug. This can increase the amount of the drug in your body, which can lead to more side effects.

For people with severe lung disease: This drug can make your condition worse. Talk with your doctor about whether this drug is safe for you.

Warnings for other groups

For pregnant people: This drug is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it’s needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask them to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit for the mother.

For people who are breastfeeding: This drug may pass into breast milk and may cause side effects in a child who is breastfed. Your child may become lethargic (drowsy) and lose weight. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: If you’re over the age of 65 years, you may be more sensitive to the sedative side effects of this drug. This means you may be more likely to be drowsy. Your doctor should monitor you closely. Also, you should take extra care to avoid falls that may be caused by drowsiness or dizziness.

For children: This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Alprazolam can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with alprazolam. This list does not contain all drugs that may interact with alprazolam.

Before taking alprazolam, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs that shouldn’t be used with alprazolam

Don’t take these drugs with Xanax. When used with Xanax, these drugs can cause dangerous effects in the body. Examples of these drugs include:

  • Opioids, such as hydrocodone or oxycodone. Taking alprazolam with an opioid increases your risk for severe sleepiness, respiratory depression, coma, and even death.
  • Certain types of antifungals, such as itraconazole or ketoconazole. When used with Xanax, these drugs can cause increased drowsiness.

Drugs that increase the risk of side effects

Taking alprazolam with certain medications raises your risk for side effects from those drugs. If you take one of these drugs with alprazolam, you may have increased drowsiness. These drugs include:

  • Barbiturates, such as:
    • amobarbital
    • butabarbital
    • pentobarbital
  • Sedatives or hypnotics, such as:
    • eszopiclone
    • zaleplon
    • zolpidem
  • Anxiolytics, such as:
    • clonazepam
    • lorazepam
    • temazepam
  • Narcotic analgesics, such as:
    • morphine
    • oxycodone
  • Sedative antihistamines, such as:
    • brompheniramine
    • chlorpheniramine
    • dimenhydrinate
    • diphenhydramine
    • doxylamine
  • Anesthetics, such as:
    • etomidate
    • propofol
    • ketamine
  • Antidepressants, such as:
    • fluvoxamine
    • fluoxetine
    • nefazodone
  • Antacids, such as:
    • cimetidine

If you take one of these drugs with alprazolam, you may have increased drowsiness or other side effects.

  • Oral contraceptives (birth control pills). If you take one of these drugs with alprazolam, you may have increased drowsiness or other side effects.

Drugs that can make alprazolam less effective

When used with alprazolam, these drugs can make alprazolam less effective. This means it won’t work as well to treat your condition. This is because the amount of alprazolam in your body is decreased. Examples of these drugs include:

  • Anticonvulsants, such as carbamazepine, phenytoin, or fosphenytoin. Your doctor may switch you to a different anticonvulsant or increase your dosage of alprazolam.

Keep these considerations in mind if your doctor prescribes alprazolam oral tablets for you.

General

  • Take this drug at the time(s) recommended by your doctor.
  • You can take this drug with or without food.
  • Do not crush or cut the oral extended-release tablet. You can cut or crush the immediate-release tablet.

Storage

  • Store this drug at room temperature, between 68°F and 77°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You shouldn’t need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be especially sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should watch for any problems with your mental health or behavior. This drug can cause new mood and behavior problems, or it may worsen problems you already have.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.