Alprazolam – dosage, uses, side effects

Dosage, Uses, Side Effects, Interaction, Warning, Precaution, Pregnancy & Breast feeding effects of Alprazolam

Alprazolam is used to treat anxiety disorders and panic disorder like sudden, unexpected attacks of extreme fear and worry about these attacks.

Alprazolam is belongs to a class of medications called Benzodiazepines. It works by decreasing abnormal excitement in to the brain.

Alprazolam may increase the risk of habit forming tendency if taken for a long duration or at larger doses. Misuse of such habit-forming medicine can cause addiction, overdose, or death.

Alprazolam belongs to same class of Diazepam and may also be used for purposes not listed in this medication guide.

 Alprazolam Classification and General Details.

  • Category : Benzodiazepines
  • Schedule : Schedule “H”
  • Prescription : Must Required
  • Legal Status : Approved
  • Available as : Tablets (0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg) , Liquid (Oral Solution) ,
  • Brand Names : Xanax , Alprax

Description of Alprazolam

Alprazolam is prescribed to treat panic disorders, insomnia and anxiety, like unexpected extreme fear and tension due to stress.

It is recommended to start with a as small as possible dosage and increase it gradually.

Do not stop taking this medicine immediately as it may cause withdrawal symptoms like seizures, aggressive behavior, blurred vision, etc.

Alprazolam can increase the risk of serious life-threatening breathing problems, sedation, or coma if used along with certain medications.

Do not drink alcohol  during your treatment.

Alprazolam dose for treatment of Anxiety
Alprazolam for treatment of Anxiety

Uses of Alprazolam

Why Alprazolam is prescribed for?

This medicine is used to manage insomnia, anxiety disorders or panic disorder. It may be used for the short-term relief of symptoms of anxiety, or anxiety linked with depression. Anxiety or hyper 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 drug therapy. It means you may need to take it with other medications.


Alprazolam drug is used in the treatment of anxiety disorders. also used for difficulty in sleeping, Uneasiness, sweating of hands and feet are some of the symptoms of an anxiety disorder.

Panic disorder

Alprazolam drug is used in the treatment of panic disorder. Sweating, weakness, breathing problem and numbness in hands are some of the symptoms of a panic disorder.

How to use Alprazolam?

Alprazolam comes in a form of tablet, extended-release tablet, orally disintegrating tablet, and a concentrated solution (liquid) to take by mouth.

The tablet, orally disintegrating tablet, and concentrated solution usually can be taken two to four times a day.

The extended-release tablet can be taken once daily, usually in the morning.

To take the concentrated liquid, use only the dropper comes with your prescription.

Obey the directions on your prescription label carefully, and ask your doctor to explain any part you do not understand. Take Alprazolam exactly as directed by practitioners.

Swallow the extended-release tablets whole; please do not chew, crush, or break them.

Alprazolam is a habit-forming drug. Do not take a higher dose, take it more often, or take it for a longer period of time than prescribed by your doctor

If you suddenly stop taking Alprazolam you may experience specific withdrawal symptoms such as..

  • Seizures
  • Shaking of a part of your body
  • Head ache
  • Blurred vision
  • Sleep difficulty
  • Light sensitivity
  • Nervousness
  • Depression
  • Wight loss

Side effects / Adverse Effects

what are the Major & minor side effects for Alprazolam?

  • Headache
  • Chest pain
  • Sleeplessness
  • Changes in pattern of speech
  • Unsteadiness
  • Weight loss
  • Double vision
  • Loss of coordination
  • Drowsiness
  • Blurred vision
  • Abdominal pain
  • Decreased appetite
  • Sudden sweating
  • Acid or sour stomach
  • Difficult or painful urination
  • Irregular menstrual periods
  • Heartburn

When not to use?

Contraindications of Alprazolam


This medicine is not recommended for use if you have a allergy to Alprazolam or other benzodiazepines like Diazepam.

Azole antifungal agents

Co-administration of Alprazolam and azole antifungal drugs like Ketoconazole and Itraconazole should be done with extreme caution. Azole antifungal drugs will increase the concentration of Alprazolam by increasing its availability in the body. This can be result in serious side effects.

What special precautions should I follow?

Before taking alprazolam ..

Tell your doctor or pharmacist if you are allergic to it or to other benzodiazepines liek diazepam, and lorazepam or if you have any other allergies.

Tell your doctor if you are taking Itraconazole or Ketoconazole.

This product may contain certain inactive ingredients, which can cause allergic reactions or other problems.

Before using this drug, tell your doctor or pharmacist about your medical history, especially of:

  • Severe lung/breathing problems such as COPD, sleep apnea,
  • Liver disease,
  • Kidney disease,
  • Overuse of or addiction to drugs/alcohol
  • Glaucoma

This mecdicine may make you dizzy or drowsy. Alcohol consuption can make you more dizzy or drowsy.

Do not drive or operate machinery.

Alprazolam drug is not recommended for use during pregnancy due to the potential for harm to unborn baby.

Breast-feeding while using this Alprazolam is not recommended.

If you are having surgery, including dental surgery, report the doctor or dentist that you are taking Alprazolam.

Dosage and Administration of Alprazolam

The Dosage of Alprazolam will depend on:

  • Patient Age ( Child / Adult / Infant etc)
  • Depend on condition being treated
  • Severity of condition
  • Any other medical conditions if you have
  • How your body reacts to the first dose

Adult dosage (Includes ages 18–64 years)

Starting dosage: 0.25–0.5 mg three times daily.

Dosage increases: Doctor may increase your dosage every 3–5 days until you reach the dosage that’s best for you.

Maximum dosage: 4 mg per day, given in divided doses.

Dosage reduction: When you’re stopping treatment, your dosage should be decreased slowly and gradually. Doctor may decrease dose by no more than 0.5 mg every 3 days.

Child dosage (Includes ages 0–17 years)

This medicine should not be used in people younger than 18 years until and unless your doctor prescribed.

Dosage for ages 65 years and older

0.25 mg, 2–3 times per day. its also depend on condition of patient with severity.

What Can i do if I miss a dose?

Take the missed dose as soon as you remember that you have missed dose.

Skip the missed dose if it is almost time for next dose. Do not take extra or double dose of medicine to make up the missed dose.

What happens if I overdose Alprazolam?

You may have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can be listed as below:

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

Seek emergency medical help or call your doctor before condition goes to worst level.

Interaction of Alprazolam

Drug/Food and Alcohol interactions may change “how your medications work” or “increase the risk for severe side / Adverse effects”. 

This drug may interact differently for person to person and condition to condition.

You should ask for all the possible interactions with your doctor before starting this medicine.

Interaction with Alcohol : MODERATE

Use of Alprazolam with alcohol will increase the central nervous system (CNS) and respiratory system depression.

Consumption of alcohol with this drug is not recommended as it increases the risk of severe respiratory depression and breathlessness.

It can also make you more drowsy or Dizzy.

Interaction with Medicine

Certain types of antifungals drugs such as itraconazole or ketoconazole  When used with this medicine can cause increased drowsiness.

With other drugs like : 

  • Cetirizine : MODERATE
  • Metoclopramide : MODERATE
  • Opioids : SEVERE
  • Azole antifungal agents : SEVERE
  • Antihypertensives : MODERATE

With Oral contraceptives  : birth control pills may increase drowsiness or other side effects.

List of Drugs which can increase the risk of side effects :


  • amobarbital
  • butabarbital
  • pentobarbital

Sedatives or hypnotics

  • eszopiclone
  • zaleplon
  • zolpidem


  • clonazepam
  • lorazepam
  • temazepam

Narcotic analgesics

  • morphine
  • oxycodone

Sedative antihistamines

  • brompheniramine
  • chlorpheniramine
  • dimenhydrinate
  • diphenhydramine
  • doxylamine


  • etomidate
  • propofol
  • ketamine


  • fluvoxamine
  • fluoxetine
  • nefazodone



Disease interactions

Glaucoma : SEVERE

Alprazolam is known to increase the fluid pressure inside the eye in few cases. Hence, it is contraindicated in patients having acute narrow-angle glaucoma which is an eye disorder.

Seizure disorders : SEVERE

This drug should be used with extreme caution in patients with a known history of seizure disorders. This drug may increase the risk of seizures. Also, suddenly stopping of Alprazolam may cause withdrawal effects and can precipitate seizures. Hence, the dose should be reduced slowly. Do not stop taking this medicine without consulting doctor.

Food interactions 

Drinking of grape fruit juice with this medicine is not recommended as it may lead to serious side effects.

Alprazolam During Pregnancy

Research in humans has shown adverse effects to the fetus when the pregnant women takes the drug.

Alprazolam is not recommended for use in pregnant women until and unless absolutely necessary and only under the supervision of the doctor.

This medicine should only be used during pregnancy in serious cases where it’s needed to treat a dangerous condition in the mother.

Alprazolam During Breast Feeding

This medicine may pass into breast milk and may cause side effects in a child who is breastfed. Alprazolam is known to be excreted into human breast milk and may cause undesired effects in the breastfed infants.

Your child may become drowsy and can lose weight. Talk to your doctor if you breastfeed your child and You may need to decide whether to stop breastfeeding or stop taking this medication.

General warnings

Drug dependency

Alprazolam has the tendency to cause dependency and abuse, particularly after a long use or excessive dosages. Patient with a history of alcohol or substance abuse should be monitored closely when they are on Alprazolam. The dosage of this drug should be tapered off gradually to avoid withdrawal symptoms.

Interdose symptoms

It may be due to the development of tolerance or insufficient dose to maintain the concentration of medicine in the body. In such situations, the same dose can be divided into multiple doses and administered more frequently.

Impaired kidney and liver function

This drug should be used with caution in individuals with impaired kidney function and liver function.

Suicidal tendency

Use of alprazolam in depression conditions may increase the risk of suicide. hence, this medicine should be used with caution and prescription size should be limited in patients with depression or suicidal tendencies.

Age less than 18 years

Use of this medicine is not recommended in individuals who are less than 18 years of age.

Elderly population

This medicine should be used with extreme caution in individuals who are 65 years old and above due to the increased risk of sedation and muscle weakness.

How Alprazolam works?

Alprazolam is a belongs to a class of benzodiazepine. It works by increasing the action of chemical messenger (GABA) which suppresses the abnormal and excessive activity of the nerve cells in to the brain.

Expert Advice for Alprazolam

If you are taking Alprazolam for the treatment of disorders like insomnia and anxiety, it should not be used more than 4 weeks.

It may become less effective over the time period.

It causes sleepiness, dizziness or drowsiness. If this happens to you, do not drive or operate machinery.

Avoid consuming alcohol when you are on Alprazolam, as it may cause excessive sleepiness or drowsiness.

Inform your doctor if you are pregnant women or planning to conceive or breastfeeding.

Inform your doctor if you have ever been diagnosed with conditions like kidney or liver problems.

The addiction tendency of Alprazolam is very high.

Other Important Details 

Onset of action (duration of time it takes for a drug’s to come in effects)

The peak effect of this drug can be observed in 1 to 2 hours for an immediate release tablet, 1.5 to 2 hours for a disintegrating tablet, and 9 hours for an extended release tablet.

Duration of effect

The effect of this drug lasts for an average duration of 44 hours for an immediate release tablet and 52 hours for an extended release tablet / disintegrating tablet.

Is it habit forming?

Yes, high Habit forming tendency has been reported.


Store this drug at a room temperature between 20°C and 25°C. and keep it out from reach of Children.

Common Questions / FAQs

What is Alprazolam drug used for?

Alprazolam is used to relieve excess anxiety and to treat anxiety associated with depression. It is not to be used for mild anxiety associated with stress of day or today’s life situations.

Is Alprazolam medication safe?

Alprazolam is safe if used at prescribed doses for the prescribed duration as per advised by doctor.

Is Alprazolam an opioid drug?

No, Alprazolam is not an opioid drug, it belongs to a class of substances called benzodiazepines.

Is Alprazolam an anti-depressant drug?

No, Alprazolam is not an anti-depressant drug. It is used to relieve excess anxiety and to treat anxiety associated with condition like depression.

Is Alprazolam drug a narcotic substance?

No, Alprazolam drug is not a narcotic substance.

Can I take Alprazolam for a hangover problem?

No, It is not indicated for managing a hangover. Rather, It should not be taken with alcohol as both the substances can cause excessive sleep or sedation and depress your brain.

Can I take Alprazolam for anxiety disorder?

Yes, Alprazolam itself is used to relieve excess (moderate to severe) anxiety and to treat anxiety associated with depression.

Can I take this medicine for heart palpitations?

No, It is not indicated for the treatment of heart palpitations. However, it may help in reducing heart palpitations associated with anxiety disorder. Alprazolam should always be taken only when advised by the doctor.

Can I take it for alcohol withdrawal?

No, Alprazolam is not indicated to manage alcohol withdrawal.

Does Alprazolam reduce (BP)blood pressure?

Lowering of blood pressure is seen if you take more than prescribed dose of this medicine. Please consult your doctor if you experience excessive fall in BP while you are taking Alprazolam.

Does this medicine make you sleepy?

Yes, It makes you sleepy. Sedation (sleepiness) is a very common side effect of this drug.

Does Alprazolam drug expire?

Yes, Obviously.. Like all other medicine has an expiry date and should not be used beyond the date mentioned on the package.

Does this therapy cause weight gain?

Change in weight gain and weight loss both has been reported as a common side effect with Alprazolam.

Can the use of Alprazolam cause hair loss problem?

No, It has not been reported to cause hair loss.

Can I take this medicine with hydrocodone?

No, Alprazolam should not be consumed with hydrocodone. Both medicine cause sedation (increased tendency to sleep) and respiratory depression (slow and difficult breathing).

Can I take Alprazolam with paracetamol?

No, an interactions have been reported between Alprazolam and paracetamol.

Can I take Alprazolam with the prednisone?

Prednisolone may increase the metabolism of Alprazolam and hence decrease the levels of Alprazolam in the body which may decrease the effect of Alprazolam and a higher dose may be needed.

Can I have Alprazolam with clonazepam?

Alprazolam should not be taken with clonazepam as both the medicines belong to the similar class of medicines called benzodiazepines. When both taken together, they can cause sedation and respiratory depression.

Can I have Alprazolam with oxycodone?

No, It should not be taken with oxycodone. Alprazolam belong to a class of medicines called benzodiazepines and oxycodone belong to the class of medicines called opioids and Both the classes cause and respiratory depression.

Can I have Alprazolam with tramadol?

No, It should not be taken with tramadol. Alprazolam belong to a class of medicines called benzodiazepines and tramadol belong to the class of medicines called opioids and Both the classes cause and respiratory depression.

Can I have Alprazolam with ibuprofen?

No, interactions have been reported between this two drugs Alprazolam and ibuprofen.

Can I have Alprazolam with sertraline?

No, interactions have been reported between these two drugs.

Can I have Alprazolam with buspirone?

No because severe interactions have been reported.

Can I consume Alprazolam for the rest of my life?

No, It should be taken only for a prescribed duration at prescribed doses as advised by your doctor.

Can I have Alprazolam for pain?

No, It is not indicated for the treatment of any kind of pain.
This information is to supplement, not substitute to the judgment of healthcare professionals. A healthcare professional should be consulted before taking any medicine, changing any diet or commencing or discontinuing any course of treatment.

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