alprazolam (Xanax, Xanax XR, Niravam) Anti-Anxiety Drug

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is Xanax, and how does it work (mechanism of action)?

Alprazolam (Xanax XR, Niravam), is an anti-anxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others. Alprazolam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders. The FDA approved alprazolam in October 1981.

What are the uses for Xanax?

Xanax is used for the treatment of anxiety disorders and panic attacks. Anxiety disorders are characterized by:

Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of Xanax.

What are the side effects of Xanax?

The most common side effects of Xanax taken at lower doses are:

Other side effects include:

Addiction is more likely to occur at high doses given over prolonged periods of time. Abrupt discontinuation of alprazolam after prolonged use can lead to symptoms of withdrawal such as:

Seizures can occur in more severe cases of withdrawal. Consequently, patients on alprazolam for extended periods of time should slowly taper the medication under a doctor's supervision rather than abruptly stopping the medication.

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What is the dosage for Xanax, and how do I take it?

  • The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
  • The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily.
  • The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
  • Alprazolam may be taken with or without food.

Which drugs or supplements interact with medication?

Is alprazolam safe to take if I'm pregnant or breastfeeding?

  • Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.
  • Alprazolam is excreted in breast milk and can affect nursing infants. Therefore, it should not be used by women who are nursing.

What else should I know about this medication?

Alprazolam is available as:

  • Tablets: 0.25, 0.5, 1 and 2 mg. 
  • Tablets ER (extended release): 0.5, 1, 2 and 3 mg.
  • Tablets (Orally disintegrating): 0.25, 0.5, 1 and 2 mg. Solution: 1 mg/ml

Keep alprazolam should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

Alprazolam is available in generic form, and you need a prescription from your doctor or other health-care professional to obtain this drug.

Brand names for alprazolam are Xanax, Xanax XR, and Niravam.

REFERENCE:

FDA Prescribing Information

Summary

Alprazolam is a member of the benzodiazepine family, which are sedatives that cause dose-related depression of the central nervous system. Alprazolam is used for the treatment of anxiety disorders and panic attacks, which cause:

It is important to be aware of the drug interactions related to alprazolam, effects on pregnancy and nursing mothers, as well as common side effects on the user.

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See more info: alprazolam on RxList
Reviewed on 6/29/2016
References
REFERENCE:

FDA Prescribing Information

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