What is alprazolam?

Alprazolam is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Alprazolam affects chemicals in the brain that may become unbalanced and cause anxiety.

Alprazolam is used to treat anxiety disorders, panic disorders, and anxiety caused by depression.

Alprazolam may also be used for other purposes not listed in this medication guide.

Precautions

It is dangerous to try and purchase alprazolam on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of alprazolam purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.

Do not use this medication if you have:

  • narrow-angle glaucoma;
  • if you are also taking itraconazole (Sporanox) or ketoconazole (Nizoral); or
  • if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).

Before taking alprazolam, tell your doctor if you are allergic to any drugs, or if you have:

  • asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
  • glaucoma;
  • kidney or liver disease (especially alcoholic liver disease);
  • a history of depression or suicidal thoughts or behavior; or
  • a history of drug or alcohol addiction.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category D. Alprazolam can cause birth defects in an unborn baby. Do not use alprazolam without your doctor’s consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

Alprazolam can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The sedative effects of alprazolam 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 alprazolam.

Do not give this medication to anyone under 18 years old.

Do not drink alcohol while taking alprazolam. This medication can increase the effects of alcohol.

Alprazolam can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Grapefruit and grapefruit juice may interact with alprazolam and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of alprazolam can be fatal.

Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, loss of balance or coordination, feeling light-headed, fainting, and coma.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • unusual risk-taking behavior, decreased inhibitions, no fear of danger;
  • depressed mood, thoughts of suicide or hurting yourself;
  • hyperactivity, agitation, hostility, hallucinations;
  • feeling light-headed, fainting;
  • seizure (convulsions);
  • urinating less than usual or not at all;
  • muscle twitching, tremor; or
  • jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • drowsiness, dizziness, feeling irritable;
  • amnesia or forgetfulness, trouble concentrating;
  • sleep problems (insomnia);
  • muscle weakness, lack of balance or coordination, slurred speech;
  • blurred vision;
  • nausea, vomiting, constipation, appetite or weight changes;
  • dry or watery mouth, increased sweating; or
  • loss of interest in sex.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Before using alprazolam, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by alprazolam.

Before taking alprazolam, tell your doctor if you are using any of the following drugs:

  • birth control pills;
  • cimetidine (Tagamet);
  • diltiazem (Tiazac, Cartia, Cardizem);
  • isoniazid (IsonaRif, Rifamate);
  • propoxyphene (Darvon, Darvocet);
  • seizure medication;
  • antibiotics such as fluconazole (Diflucan), itraconazole (Sporanox) or ketoconazole (Nizoral); or
  • antidepressants such as fluvoxamine (Luvox), desipramine (Norpramin), or imipramine (Janimine, Tofranil).

This list is not complete and there may be other drugs that can interact with alprazolam. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Other Names

Niravam, Xanax, Xanax XR, and alprazolam

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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