Description and Brand Names

Información sobre medicamentos proporcionada por: IBM Micromedex

US Brand Name

  1. Gabazolamine-05
  2. Niravam
  3. Xanax
  4. Xanax XR

Canadian Brand Name

  1. Alti-ALPRAZolam

Descriptions


Alprazolam is used to relieve symptoms of anxiety, including anxiety caused by depression. It is also used to treat panic disorder in some patients.

Alprazolam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet
  • Tablet, Disintegrating
  • Solution
  • Tablet, Extended Release

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of alprazolam in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of alprazolam in the elderly. However, elderly patients are more likely to have unwanted effects (eg, severe drowsiness, dizziness, confusion, clumsiness, or unsteadiness) and kidney, liver, or lung problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Breastfeeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Boceprevir
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Flumazenil
  • Idelalisib
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Lopinavir
  • Nefazodone
  • Nelfinavir
  • Posaconazole
  • Saquinavir
  • Telaprevir
  • Telithromycin
  • Voriconazole

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abametapir
  • Acepromazine
  • Alfentanil
  • Amiodarone
  • Amobarbital
  • Amprenavir
  • Anileridine
  • Aprepitant
  • Aripiprazole
  • Aripiprazole Lauroxil
  • Asenapine
  • Atazanavir
  • Baclofen
  • Benperidol
  • Benzhydrocodone
  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Buspirone
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Calcium Oxybate
  • Cannabidiol
  • Carbamazepine
  • Carbinoxamine
  • Carisoprodol
  • Carphenazine
  • Ceritinib
  • Cetirizine
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpromazine
  • Chlorzoxazone
  • Cimetidine
  • Ciprofloxacin
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Codeine
  • Crizotinib
  • Cyclobenzaprine
  • Cyclosporine
  • Dantrolene
  • Darunavir
  • Dasabuvir
  • Delavirdine
  • Dexmedetomidine
  • Diacetylmorphine
  • Diazepam
  • Dichloralphenazone
  • Difenoxin
  • Digoxin
  • Dihydrocodeine
  • Diltiazem
  • Diphenhydramine
  • Diphenoxylate
  • Domperidone
  • Doxylamine
  • Dronedarone
  • Droperidol
  • Elagolix
  • Enflurane
  • Erythromycin
  • Esketamine
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Ethopropazine
  • Ethylmorphine
  • Fentanyl
  • Flibanserin
  • Fluconazole
  • Flunitrazepam
  • Fluphenazine
  • Flurazepam
  • Fluspirilene
  • Fluvoxamine
  • Fosamprenavir
  • Fosaprepitant
  • Fosnetupitant
  • Fospropofol
  • Gabapentin
  • Gabapentin Enacarbil
  • Halazepam
  • Halothane
  • Hexobarbital
  • Hydrocodone
  • Hydromorphone
  • Hydroxyzine
  • Imatinib
  • Isoflurane
  • Ivacaftor
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Larotrectinib
  • Lemborexant
  • Letermovir
  • Levocetirizine
  • Levorphanol
  • Lofexidine
  • Lomitapide
  • Lorazepam
  • Loxapine
  • Magnesium Oxybate
  • Meclizine
  • Melperone
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Methylene Blue
  • Metoclopramide
  • Mibefradil
  • Midazolam
  • Mifepristone
  • Mirtazapine
  • Molindone
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Netupitant
  • Nicomorphine
  • Nilotinib
  • Nitrazepam
  • Nitrous Oxide
  • Olanzapine
  • Opium
  • Opium Alkaloids
  • Orphenadrine
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Palbociclib
  • Papaveretum
  • Paregoric
  • Pentazocine
  • Pentobarbital
  • Perampanel
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenobarbital
  • Pimozide
  • Piperacetazine
  • Piperaquine
  • Pipotiazine
  • Piritramide
  • Potassium Oxybate
  • Prazepam
  • Pregabalin
  • Primidone
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propofol
  • Quazepam
  • Quetiapine
  • Ramelteon
  • Ranitidine
  • Ranolazine
  • Remifentanil
  • Remimazolam
  • Remoxipride
  • Ritonavir
  • Scopolamine
  • Secobarbital
  • Sertindole
  • Sodium Oxybate
  • Sufentanil
  • Sulpiride
  • Suvorexant
  • Tapentadol
  • Temazepam
  • Thiethylperazine
  • Thiopental
  • Thiopropazate
  • Thioridazine
  • Tilidine
  • Tizanidine
  • Tolonium Chloride
  • Topiramate
  • Tramadol
  • Trazodone
  • Triazolam
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Verapamil
  • Voxelotor
  • Zaleplon
  • Zolpidem
  • Zopiclone
  • Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Fluoxetine
  • Kava
  • Rifapentine
  • Roxithromycin
  • Sertraline
  • St John's Wort
  • Theophylline
  • Troleandomycin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol
  • Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol or drug abuse or dependence, history of or
  • Depression, or history of or
  • Lung or breathing problems (eg, respiratory depression) or
  • Mania, or history of or
  • Mental health problems, or history of or
  • Seizures, or history of—Use with caution. May make these conditions worse.
  • Glaucoma, acute narrow angle—Should not be used in patients with this condition.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much of this medicine is used for a long time, it may become habit-forming (causing mental or physical dependence) or cause an overdose.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the extended-release tablet or tablet whole with a full glass of water. Do not break, crush, or chew it.

If you are using the orally disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not remove the tablets from the bottle until you are ready to take it. Place the tablet immediately on the top of your tongue. It should melt quickly and be swallowed with saliva.

If you are using the oral liquid, measure the dose with a marked measuring spoon, oral syringe, or medicine cup.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For anxiety:
    • For oral dosage forms (solution, tablets, or orally disintegrating tablets):
      • Adults—At first, 0.25 to 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 4 mg per day.
      • Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.
      • Children—Use and dose must be determined by your doctor.
  • For panic disorder:
    • For oral dosage form (extended-release tablets):
      • Adults—At first, 0.5 to 1 milligram (mg) taken in the morning once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.
      • Older adults—At first, 0.5 mg taken in the morning once a day. Your doctor may increase your dose as needed.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage forms (solution, tablets, or orally disintegrating tablets):
      • Adults—At first, 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.
      • Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

It is very important to protect the orally disintegrating tablets from moisture. Remove and throw away any cotton packaging from the medicine bottle when you first use the medicine.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not take itraconazole (Sporanox®) or ketoconazole (Nizoral®) while you are using this medicine. Using any of them together with this medicine may increase the chance of serious side effects.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or seizure medicines, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop using this medicine. Check with your doctor before taking any of the above while you are using this medicine.

If you develop any unusual and strange thoughts or behavior while you are taking alprazolam, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

Alprazolam may cause some people, especially older persons, to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy, or are not alert or able to see well.

Do not change your dose or stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms including changes in behavior, discouragement, feeling sad or empty, irritability, lack of appetite, loss of interest or pleasure, nausea or vomiting, seeing or hearing things that others do not see or hear, seizures or tremors, stomach or muscle cramps, sweating, thoughts of killing oneself, trouble concentrating, trouble sleeping, unusual movements, responses, or expressions.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Symptoms of an overdose include: change in consciousness, confusion, drowsiness, lack of coordination, loss of consciousness, or sleepiness. Call your doctor right away if you notice these symptoms.

Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Being forgetful
  2. changes in patterns and rhythms of speech
  3. clumsiness or unsteadiness
  4. difficulty with coordination
  5. discouragement
  6. drowsiness
  7. feeling sad or empty
  8. irritability
  9. lack of appetite
  10. lightheadedness
  11. loss of interest or pleasure
  12. relaxed and calm
  13. shakiness and unsteady walk
  14. sleepiness
  15. slurred speech
  16. tiredness
  17. trouble concentrating
  18. trouble performing routine tasks
  19. trouble sleeping
  20. trouble speaking
  21. unsteadiness, trembling, or other problems with muscle control or coordination
  22. unusual tiredness or weakness

Less common

  1. Blurred vision
  2. body aches or pain
  3. burning, crawling, itching, numbness, prickling, "pins and needles, or tingling feelings
  4. changes in behavior
  5. chills
  6. clay-colored stools
  7. confusion about identity, place, and time
  8. cough
  9. dark urine
  10. decrease in frequency of urination
  11. decrease in urine volume
  12. diarrhea
  13. difficult or labored breathing
  14. difficulty in passing urine (dribbling)
  15. difficulty with concentration
  16. difficulty with moving
  17. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  18. dry mouth
  19. ear congestion
  20. environment seems unreal
  21. fainting
  22. feeling of unreality
  23. feeling warm
  24. fever
  25. general feeling of discomfort or illness
  26. headache
  27. inability to move the eyes
  28. inability to sit still
  29. increased blinking or spasms of the eyelid
  30. irregular heartbeats
  31. itching or rash
  32. joint pain
  33. lack or loss of self-control
  34. loss of bladder control
  35. loss of coordination
  36. loss of memory
  37. loss of voice
  38. mood or mental changes
  39. muscle aches, cramps, pain, stiffness, or weakness
  40. nausea
  41. need to keep moving
  42. painful urination
  43. problems with memory
  44. restlessness
  45. runny or stuffy nose
  46. seeing, hearing, or feeling things that are not there
  47. seizures
  48. sense of detachment from self or body
  49. shaking
  50. shivering
  51. sneezing
  52. sore throat
  53. sticking out of the tongue
  54. stomach pain
  55. sweating
  56. swollen joints
  57. talkativeness
  58. tightness in the chest
  59. trouble with balance
  60. twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
  61. uncontrolled twisting movements of the neck, trunk, arms, or legs
  62. unpleasant breath odor
  63. unusual dullness or feeling of sluggishness
  64. unusual facial expressions
  65. unusually deep sleep
  66. unusually long duration of sleep
  67. vomiting of blood
  68. yellow eyes or skin

Rare

  1. Actions that are out of control
  2. attack, assault, or force
  3. chest pain
  4. continuing ringing or buzzing or other unexplained noise in the ears
  5. decreased awareness or responsiveness
  6. deep or fast breathing with dizziness
  7. ear pain
  8. false or unusual sense of well-being
  9. fast, irregular, pounding, or racing heartbeat or pulse
  10. feeling jittery
  11. feeling unusually cold
  12. generalized slowing of mental and physical activity
  13. hearing loss
  14. hoarseness
  15. lack of feeling or emotion
  16. loss of control of the legs
  17. loss of strength or energy
  18. nightmares
  19. numbness of the feet, hands, and around mouth
  20. severe sleepiness
  21. shakiness in the legs, arms, hands, or feet
  22. sleep talking
  23. swelling
  24. talking, feeling, and acting with excitement
  25. thoughts of killing oneself
  26. uncaring
  27. unusual weak feeling
  28. voice changes

Incidence not known

  1. Light-colored stools
  2. upper right abdominal or stomach pain

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  1. Change in consciousness
  2. confusion
  3. lack of coordination
  4. loss of consciousness
  5. sleepiness or unusual drowsiness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Absent, missed, or irregular menstrual periods
  2. decreased appetite
  3. decreased interest in sexual intercourse
  4. decreased sexual performance or desire abnormal ejaculation
  5. difficulty having a bowel movement (stool)
  6. inability to have or keep an erection
  7. increased appetite
  8. increased in sexual ability, desire, drive, or performance
  9. increased interest in sexual intercourse
  10. increased weight
  11. loss in sexual ability, desire, drive, or performance
  12. stopping of menstrual bleeding
  13. watering of the mouth
  14. weight loss

Less common

  1. Blistering, crusting, irritation, itching, or reddening of the skin
  2. change in taste bad unusual or unpleasant (after) taste
  3. cracked, dry, or scaly skin
  4. double vision
  5. feeling of warmth
  6. heavy bleeding
  7. menstrual changes
  8. pelvic pain
  9. redness of the face, neck, arms, and occasionally, upper chest
  10. seeing double
  11. stomach bloating and cramping
  12. sudden sweating
  13. unexplained runny nose or sneezing

Rare

  1. Acid or sour stomach
  2. belching
  3. bigger, dilated, or enlarged pupils (black part of the eye)
  4. change in color vision
  5. difficulty seeing at night
  6. feeling of constant movement of self or surroundings
  7. feeling of relaxation
  8. heartburn
  9. hives or welts
  10. increased sensitivity of the eyes to sunlight
  11. indigestion
  12. redness of the skin
  13. sensation of spinning
  14. stomach discomfort or upset

Incidence not known

  1. Blistering, peeling, or loosening of the skin
  2. red, irritated eyes
  3. red skin lesions, often with a purple center
  4. sores, ulcers, or white spots in the mouth or on the lips
  5. swelling of the breasts or breast soreness in both females and males
  6. unexpected or excess milk flow from the breasts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.