SIDE EFFECTS: Drowsiness, dizziness, headache, tiredness, clumsiness, decreased interest in sex, decreased appetite, nausea, constipation, or joint pain may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these serious side effects occur: mental/mood changes, confusion, slurred speech or difficulty speaking, difficulty remembering things. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Before taking alprazolam, tell your doctor or pharmacist if you are allergic to it; or to other benzodiazepines (e.g., diazepam, lorazepam); or if you have any other allergies. Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, severe lung/breathing problems (e.g., COPD, sleep apnea), drug or alcohol abuse. This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages. Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially loss of coordination and drowsiness. This medication is not recommended for use during pregnancy due to the potential for fetal harm. Consult your doctor for more details. This drug passes into breast milk and may have undesirable effects on a nursing infant. Therefore, breast-feeding while using this medication is not recommended. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: See also the How to Use section. This drug should not be used with the following medications because very serious interactions may occur: certain azole antifungals (e.g., itraconazole, ketoconazole), delavirdine, sodium oxybate. If you are currently using any of these medications, tell your doctor or pharmacist before starting alprazolam. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: clozapine, digoxin, disulfiram, kava. Tell your doctor or pharmacist if you take drugs that affect the removal of alprazolam from your system (CYP 3A4 substrates, inhibitors and inducers) such as: other azole antifungals (e.g., fluconazole, voriconazole), certain anti-depressants (e.g., fluoxetine, fluvoxamine, nefazodone), certain anti-seizure medications (e.g., phenytoin, phenobarbital), cimetidine, macrolide antibiotics (e.g., erythromycin, clarithromycin), rifamycins (e.g., rifampin), ritonavir, St John's wort. Tell your doctor or pharmacist if you take drugs that cause drowsiness such as: antihistamines that cause drowsiness (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep (e.g., sedatives), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., phenothiazines such as chlorpromazine, tricyclic anti-depressants such as amitriptyline), tranquilizers. Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients which cause drowsiness. Ask your pharmacist about the safe use of those products. Cigarette smoking decreases blood levels of this medication (through liver enzyme induction). Tell your doctor if you smoke or if you have recently stopped smoking because your dose may need to be adjusted. Do not start or stop any medicine without doctor or pharmacist approval.