Table of Contents

  1. What is Alprazolam?
  2. Alprazolam composition
  3. History behind the Alprazolam
  4. Alprazolam Indications
  5. How does Alprazolam work? (Alprazolam Mechanism of Action)
  6. How to Take Alprazolam?
  7. Common Alprazolam Dose
  8. When to Avoid Alprazolam?
  9. Alprazolam Side Effects
  10. Effects on organs
  11. Warnings and Precautions
  12. Reported Allergic Reactions
  13. Effect of Alprazolam on the menstrual cycle
  14. Drug Interactions To Be Careful About
  15. Food interactions of Alprazolam
  16. Interactions with laboratory procedures
  17. How Long Does the Effect Stay?
  18. Is Alprazolam Addictive?
  19. Can I have Alprazolam with alcohol?
  20. Can I have Alprazolam When Pregnant?
  21. Can I have Alprazolam when feeding a baby?
  22. Can I drive after taking Alprazolam?
  23. Effect of an overdose of Alprazolam
  24. Effect of using expired Alprazolam
  25. Effect of missing a dose of Alprazolam
  26. Storage requirements
  27. Substitutes for Alprazolam
  28. Resources

What is Alprazolam?

Alprazolam is a prescription medicine used to treat neurological disorders like anxiety and panic disorders. Let’s explore detailed information about this medicine.

Alprazolam composition

Alprazolam is the generic name and is a key component is some branded medicine like Xanax, Xanax XR, Alprazolam Intensol, Niravam. Alprazolam belongs to class of drugs called Benzodiazepines.

History behind the Alprazolam

Alprazolam got patented in 1971 and got approval for medical use in 1981. This is categorized as a schedule IV controlled substance and is known to be a common drug of abuse. Alprazolam was listed as 21st medicine in the most commonly prescribed medication in 2017 in the United States ranging to 25 million prescriptions.

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Alprazolam Indications

  • Anxiety disorders
  • Panic disorders
  • Anxiety caused by depression

How does Alprazolam work? (Alprazolam Mechanism of Action)

Alprazolam is short-acting Benzodiazepines. Alprazolam works on Central Nervous System (CNS) and results in a calming effect. Id does it by binding to GABA receptors in the brain cells. Low levels of GABA receptors are known to be the cause of anxiety and panic disorders.

How to Take Alprazolam?

Alprazolam is available as oral tablets and is used as any other oral pills with a glass of pure water. It is advised to swallow the entire tablet without chewing or crushing the tablet.

Common Alprazolam Dose

Alprazolam is available in different doses and the prescription dose depends on various factors like the condition being treated, age of the patient. It is commonly prescribed to take 2 times a day or 3 times a day. Your doctor would decide the dose needed based on all these factors.

When to Avoid Alprazolam?

Alprazolam is not safe to use in some patients preferable if suffering from some ailments like –

  • Myasthenia gravis
  • Acute narrow-angle glaucoma
  • Severe liver deficiencies
  • Severe sleep apnea
  • Pre-existing respiratory depression
  • Marked Neuromuscular Respiratory disorders
  • Acute pulmonary insufficiency
  • Chronic psychosis
  • Allergy or Hypersensitivity to Alprazolam or any Benzodiazepines

Advised to avoid or if unavoidable t is advised to use with proper medical supervision in conditions like –

  • Children
  • Drug dependent individuals
  • People with substance abuse history like alcohol abuse
  • People with comorbid psychiatric disorders
  • Pregnant and elder group patients

Alprazolam Side Effects

Alprazolam may show some side effects in some patients as mentioned below. It is advised to consult your doctor if these side effects don’t go away after a short period.

  • Insomnia
  • Sleepiness
  • Depression
  • Headaches
  • Feeling tired
  • Dry mouth
  • Memory problems
  • Ataxia
  • Cognitive dysfunction
  • Constipation
  • Depression
  • Difficulty in micturition
  • Drowsiness
  • Dysarthria
  • Fatigue
  • Headache
  • Memory Impairment
  • Menstrual Disease
  • Nervousness
  • Sedated State
  • Skin Rash
  • Tremor
  • Weight Gain
  • Weight Loss
  • Anxiety
  • Blurred Vision
  • Diarrhea
  • Decreased Libido
  • Increased Appetite
  • Irritability
  • Decreased Appetite

Effects of Alprazolam on Organs

Alprazolam may affect vital organs if it has overdosed. This medicine is metabolized in the liver and eliminated through kidneys. Hence, it can show adverse effects on these organs in heavy doses. Alprazolam can also effect on heartbeat and shallow breathing if overdosed.

Warnings and Precautions

Alprazolam has to be used with precaution and medical supervision in some populations like the elderly, pregnant, patients with impairments of the liver, kidney, patients with eye-related problems, candidates with known issues of alcohol abuse or drug abuse, etc. Precaution has to be taken in case of people using other medications.

Reported Allergic Reactions

Rarely some severe allergic reactions may be noticed like hives, rashes, swelling of facial organs, throat. It is advised to consult your doctor or medical emergency if such allergic reactions are seen.

Effect of Alprazolam on the menstrual cycle

Alprazolam can alter the menstrual cycles and also can cause the premenstrual syndrome. Consult your gynecologist for further evaluation if you are about to use this medicine.

Alprazolam Drug Interactions to Be Careful About

CYP3A4 (Cytochrome P450 3A4) is the enzyme found in the liver which is the key enzyme that metabolized the Alprazolam in the liver. Using certain medicines that inhibit this enzyme can result in the accumulation of the Alprazolam in the liver. Below mentioned are some examples of medicines prescribed to inhibit the CYP3A4 enzyme. It is advised to avoid using such medicine along with Alprazolam to avoid complications.

  • Cimetidine
  • Erythromycin
  • Norfluoxetine
  • Fluvoxamine
  • Itraconazole
  • Ketoconazole
  • Nefazodone
  • Propoxyphene
  • Ritonavir

This is not a comprehensive list of drugs that Alprazolam can show drug interactions. It is advised to share the details about your current list of medications including prescription and non-prescription medications with your doctor to avoid drug interaction complications.

Food interactions of Alprazolam

There are no particular lists of food interactions indicated in the case of Alprazolam. However alcohol is one of the items to be completely avoided as the synergic effect of alcohol and Alprazolam can aggravate the sedative effect which can lead to severe life-threatening complications like decreased breathing, decreased heartbeat, and coma, sometimes even lead to death.

Caffeine is one more thing that is advised to avoid using in high dosed while you are using Alprazolam since these two items differently and in the opposite way. Grapefruit also may reduce the metabolism of the Alprazolam.

Interactions with laboratory procedures

No consistent interactions with particular laboratory procedures are noticed in the case of Alprazolam. As a general practice, inform your doctor know about the prescription before attending any diagnostic tests.  

How Long Does the Effect Stay?

The effect of the Alprazolam starts working (onset of action of Alprazolam) in less than an hour. Duration of action is 6 hours and elimination half-life is 11 to 13 hours in case of immediate-release versions and it would be 11 to 16 hours in case of extended release versions.

Is Alprazolam Addictive?

Yes, Alprazolam is addictive particularly in the case of patients with a history of drug abuse or alcohol abuse.

Can I have Alprazolam with alcohol?

No, Alprazolam is not advised to take along with alcohol or consumption of alcohol is not advised while using this medication as the synergic effect of both alcohol and Alprazolam can cause adverse effects like severe dizziness, unconsciousness, shallow breathing, and coma and eventually lead to death.  

Can I have Alprazolam When Pregnant?

Not recommended to use in pregnancy particularly in the final trimester as the risk of fatal effects on the fetus is more.

Can I have Alprazolam when feeding a baby?

Not advised in nursing mothers as the prolonged use may cause lethargy and weight loss in infants.

Can I drive after taking Alprazolam?

Alprazolam causes dizziness and is not advised to do activities like driving and operating machines that require alertness.

Effect of an overdose of Alprazolam

Overdose of Alprazolam can cause severe adverse effects like severe sleepiness, shallow breathing, confusion, impaired coordination, diminished reflexes, and coma.

Effect of using expired Alprazolam

Expired medicine may not give the intended benefits, but as a general practice, it is not advised to use expired medicine. Dispose of the expired medicine properly.

Effect of missing a dose of Alprazolam

Missing a single dose may not have any severe impact. Not advised to take an excess dose to cover the missed dose, but to skip the missed dose and continue with the next regular dose.

Storage requirements

Alprazolam is advised to store at room temperature away from direct heat and sunlight, never freeze and store away from reach to pets and kids.

Substitutes for Alprazolam

Below mentioned are different medicines that belong to the same class of drugs called Benzodiazepines to which Alprazolam belongs and may be prescribed as an alternative to Alprazolam.    

  • Clobazam (Onfi)
  • Clonazepam (Klonopin)
  • Clorazepate (Tranxene)
  • Chlordiazepoxide (Librium)
  • Diazepam (Valium, Diastat Acudial, Diastat)
  • Lorazepam (Ativan)
  • Temazepam (Restoril)
  • Triazolam (Halcion)



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