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:

• Glaucoma
• Kidney disease
• Liver disease
• Lung disease, such as asthma or COPD
• Mental health conditions
• Substance use disorder
• Suicidal thoughts, plans, or attempt by you or a family member
• An unusual or allergic reaction to alprazolam, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

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.

People 65 years and older 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:

• Chloramphenicol
• Clarithromycin
• Grapefruit juice
• Levoketoconazole
• Lonafarnib
• Mifepristone
• Sodium oxybate
• Some antivirals for HIV or hepatitis
• Some medications for cancer, such as adagrasib, ceritinib, idelalisib, ribociclib, tucatinib
• Some medications for fungal infections, such as ketoconazole, itraconazole, posaconazole, voriconazole

This medication may also interact with the following:

• Alcohol
• Cimetidine
• Digoxin
• Medications that cause drowsiness before a procedure, such as propofol
• Medications that help you fall asleep
• Medications that relax muscles
• Opioids for pain or cough
• Other benzodiazepines
• Phenothiazines, such as chlorpromazine, prochlorperazine, thioridazine
• Some antihistamines
• Some medications for depression, such as amitriptyline or trazodone
• Some medications for seizures, such as phenobarbital or primidone
• Supplements, such as green tea, melatonin, St. John's wort, valerian

Other medications may affect the way this medication works. Talk with your care team about all the medications you take. They may suggest changes to your treatment plan to lower the risk of side effects and to make sure your medications work as intended.

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.

There is a risk of abuse, misuse, and addiction with this medication. It is important to take this medication as directed by your care team.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

This medication is a CNS depressant. This is a type of medication or substance that slows down your brain and nervous system. Taking it with other CNS depressants can make you too sleepy. This can make it hard to breathe and stay awake. In some cases, it can cause coma and death. CNS depressants include opioids, benzodiazepines, muscle relaxants, medications for sleep, alcohol, and street drugs. Talk to your care team about all the medications, vitamins, and supplements you take. They can tell you what is safe to take together. Call emergency services right away if you have slow or shallow breathing, feel dizzy or confused, or have trouble staying awake.

Do not stop taking this medication or reduce your dose without first talking to your care team. If you have taken this medication for a long time or take a high dose, your body may rely on it. Stopping it suddenly may cause a severe reaction. Talk to your care team about how long you need to take this medication. When it is time to stop, the dose will be slowly lowered over time to reduce the risk of side effects.

This medication may worsen depression and cause thoughts of suicide. This can happen at any time but is more common after first starting treatment and after a change in dose. Talk to your care team right away if you have changes in mood and behavior or thoughts of self-harm or suicide. They can help you.

Talk to your care team if you may be pregnant. Prolonged use of this medication during pregnancy can cause temporary withdrawal in a newborn.

Talk to your care team before breastfeeding. Changes to your treatment plan may be needed. If you breastfeed while taking this medication, seek medical care right away if you notice the child has slow or noisy breathing, is unusually sleepy or not able to wake up, or is limp.

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 these to your care team if they continue or are bothersome):

• Change in sex drive or performance
• Dizziness
• Drowsiness
• Loss of balance or coordination

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 this medication out of reach of children and pets. Store it out of sight in a safe place. Do not share it with others. Misuse of 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. To get rid of this medication:

• Take the medication to a take-back program. Check with your pharmacy or law enforcement to find a location.
• Follow the steps given to you by your pharmacy. You may be given a pre-paid mail-back envelope or disposal product to safely get rid of your medication.
• If other options are not available, check the package insert or medication guide to see if it should be flushed down the toilet or put in your trash at home. If you are not sure, ask your care team. If it is safe to put it in your trash, empty the medication out of the container. Mix it with cat litter, dirt, used coffee grounds, or another unwanted substance. Seal the mixture in a container, such as a plastic bag. 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.