Alprazolam

Alprazolam is a benzodiazepine prescribed for anxiety and panic disorder. Immediate-release and extended-release formulations have different schedules; XR is used for panic disorder.

It strengthens the action of GABA, a chemical messenger that reduces nerve-cell activity. This can relieve anxiety while also slowing alertness, memory, and coordination.

Effects can begin after the first dose. The timing and duration depend on the formulation and dose. Sleepiness or impaired coordination may last longer than the relief you notice.

Your provider should review whether ongoing treatment is helping and whether the dose or duration should change. Do not increase the dose when the effect seems weaker.

• Follow the exact schedule, including whether use is scheduled or as needed. Do not add doses for breakthrough symptoms without instructions.
• Swallow XR tablets whole. Use the supplied measuring device for a liquid formulation.
• If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
• Do not stop suddenly after regular use. Consult with your provider about a gradual taper.

• Sleepiness, slowed reactions, or fatigue
• Dizziness, poor balance, or falls
• Memory problems or difficulty concentrating

Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.

Watch for daytime sedation, falls, memory changes, and breathing problems. Older adults and people taking other sedatives may be more sensitive.

Physical dependence can develop with regular use. Sudden stopping or a rapid reduction can cause severe withdrawal, including seizures. Dependence is different from addiction, but misuse and addiction are also possible.

For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.

Discuss sleep apnea, lung disease, liver or kidney disease, glaucoma, falls, and any history of substance use problems. Tell your provider about all opioids and other sedatives.

Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.

Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.

Combining a benzodiazepine with an opioid can cause profound sedation, slowed breathing, coma, or death. Use such combinations only under a specifically reviewed treatment plan.

Avoid alcohol. Sleeping pills, sedating antihistamines, muscle relaxants, and other sedatives can increase impairment and breathing risks.

Some antifungals, antibiotics, and other strong CYP3A inhibitors can make alprazolam unsafe. Ritonavir requires specific management. Grapefruit can also affect exposure; check before using it.

Do not drive until you know how the medication affects you. Avoid driving whenever sleepy or impaired.

Keep medication locked away. Never share it, even with someone who has similar symptoms.

Arrange refills or taper instructions before you run out.

Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.