Alprazolam Tablets

What is this medication?

ALPRAZOLAM (al PRAY zoe lam) treats anxiety. It works by helping your nervous system calm down. It belongs to a group of medications called benzodiazepines.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Xanax

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Depression or other mental health disease
• History of alcohol or drug abuse or addiction
• Kidney disease
• Liver disease
• Lung disease, asthma, or breathing problem
• Seizures
• Suicidal thoughts, plans or attempt
• An unusual or allergic reaction to alprazolam, other benzodiazepines, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth. Take it as directed on the prescription label. Do not take it more often than directed. Keep taking it unless your care team tells you to stop.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Patients over 65 years of age may have a stronger reaction and need a smaller dose.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Certain antivirals for HIV or hepatitis
• Certain medications for fungal infections like ketoconazole, itraconazole, or posaconazole
• Clarithromycin
• Grapefruit juice
• Narcotic medications for cough
• Sodium oxybate

This medication may also interact with the following:

• Alcohol
• Antihistamines for allergy, cough and cold
• Certain medications for anxiety or sleep
• Certain medications for depression like amitriptyline, fluoxetine, fluvoxamine, nefazodone, sertraline
• Certain medications for seizures like carbamazepine, phenobarbital, phenytoin, primidone
• Cimetidine
• Digoxin
• Erythromycin
• Female hormones, like estrogens or progestins and birth control pills, patches, rings, or injections
• General anesthetics like halothane, isoflurane, methoxyflurane, propofol
• Medications that relax muscles
• Narcotic medications for pain
• Phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.

Do not stop taking except on your care team's advice. You may develop a severe reaction. Your care team will tell you how much medication to take.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. To reduce the risk of dizzy and fainting spells, do not stand or sit up quickly, especially if you are an older patient. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

If you are taking another medication that also causes drowsiness, you may have more side effects. Give your care team a list of all medications you use. Your care team will tell you how much medication to take. Do not take more medication than directed. Call emergency services if you have problems breathing or unusual sleepiness.

Women should inform their care team if they wish to become pregnant or think they might be pregnant. Do not breast-feed while taking this medication. Talk to your care team for more information.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• CNS depression—slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake
• Thoughts of suicide or self-harm, worsening mood, feelings of depression

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Change in sex drive or performance
• Dizziness
• Drowsiness
• Nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets. This medication can be abused. Keep it in a safe place to protect it from theft. Do not share it with anyone. It is only for you. Selling or giving away this medication is dangerous and against the law.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Get rid of any unused medication after the expiration date.

This medication may cause harm and death if it is taken by other adults, children, or pets. It is important to get rid of the medication as soon as you no longer need it, or it is expired. You can do this in two ways:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What is Xanax for?

Alprazolam (Xanax®) has approval from the U.S. Food and Drug Administration (FDA) to help manage the following conditions:

• Anxiety disorders, including generalized anxiety disorder.
• Panic disorder with or without agoraphobia.

Providers sometimes prescribe Xanax for other conditions. This is considered an off-label, or non-FDA-approved, use of the medication. Off-label uses of Xanax include:

• Certain symptoms of depression.
• Insomnia.
• Premenstrual syndrome.

How long does Xanax stay in your system?

The half-life of alprazolam (Xanax) is about 11 hours in adults. This means that it takes about 11 hours for the active ingredient in the medication to reduce by half in your body. In other words, if you were to take a single dose of alprazolam, the medication would likely be completely out of your system 22 hours after you take it.

Is Xanax addictive?

Yes, alprazolam (Xanax) and other benzodiazepines have addiction potential. This means that they strongly activate the reward center of your brain and can produce feelings of pleasure. Not everyone who has a prescription for Xanax develops an addiction. When you carefully follow your prescription instructions for the medication, the chance of developing a substance use disorder is low. Your risk increases if you misuse the medication.

A substance use disorder can significantly impact your health, relationships and overall quality of life. It can also be life-threatening. If you feel like you’re becoming dependent on Xanax or are taking it more than what your healthcare provider has prescribed, seek help as soon as possible.

Can you take Xanax while pregnant?

There are certain risks and benefits associated with taking benzodiazepines, including Xanax, while pregnant. Because of this, you should talk to your healthcare provider about it. They make recommendations on a case-by-case basis because each person is unique. It’s ideal to have these conversations before you try to become pregnant.

An analysis of 14 studies on pregnancy and delivery outcomes after exposure to benzodiazepines showed that taking benzodiazepines while pregnant was associated with an increased risk of:

• Miscarriage (spontaneous abortion).
• Premature birth.
• Low birth weight.
• Low Apgar score.
• Neonatal intensive care unit (NICU) admission.

One study on Xanax usage specifically during pregnancy showed an increased risk of:

• Miscarriage.
• Low birth weight.
• Apgar score at or below 7 one minute after birth.

It's important to remember that the benefits of taking Xanax during pregnancy to manage an underlying mental health condition may outweigh the potential risks. Untreated or undertreated mental health conditions during pregnancy can lead to an increased risk of:

• Not taking prenatal care measures (like taking prenatal vitamins and attending prenatal appointments).
• Inadequate nutrition.
• Increased alcohol and tobacco use.

Untreated anxiety during pregnancy can also increase your risk of postpartum anxiety.

Does Xanax cause weight gain?

Xanax can sometimes cause appetite changes and weight gain as side effects. But it’s important to remember that several factors can contribute to weight gain. For example:

• Adults tend to gain weight as they age in general.
• You may develop different exercise or eating patterns that are unrelated to the medication itself.

If you’re concerned about this possible side effect, talk to your healthcare provider. Know that the benefits of taking Xanax may override possible weight gain.

Does Xanax make you sleep?

Xanax and other benzodiazepines have sedative effects, which means they can make you feel drowsy and sleepy. However, some people experience sleep problems (insomnia) as a side effect of Xanax.

Only take Xanax as prescribed. Talk to your healthcare provider if you’re experiencing excessive sleepiness or difficulty sleeping.