It’s an antianxiety medication in the benzodiazepine family. This is the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others.

It works by decreasing abnormal excitement in the brain. The Food and Drug Administration (FDA) approved it in October 1981.

Benzodiazepines act on the brain and central nervous system (CNS) to produce a calming effect.

It slows down the movement of brain chemicals that may have become unbalanced, resulting in a reduction in nervous tension and anxiety. Alprazolam works by boosting the effects of a natural chemical called gamma-aminobutyric acid, which is made in the brain.

To ensure the safe and effective use of benzodiazepines, doctors will provide the following guidance to anyone with a alprazolam prescription:

• People should inform their doctor about any alcohol consumption and any medications they are currently taking, including over-the-counter (OTC) medications. People generally should not consume alcohol while taking benzodiazepines.
• Doctors do not recommend this medicine for use in pregnancy. A person should inform their doctor if they are pregnant, are planning to have a child, or become pregnant while they are taking this medication.
• People should inform their doctor if they are breastfeeding.
• Until a person experiences how it affects them, they should not drive a car or operate heavy or dangerous machinery.
• People should not increase the dosage of alprazolam without speaking with a doctor, even if they think that the medication “does not work anymore.” Benzodiazepines, even if a person uses them as recommended, may produce emotional and physical dependence.
• People should not stop taking this medication abruptly or decrease the dosage without consulting their doctor, as withdrawal symptoms can occur.

A person should inform their doctor if they have:

• asthma or other breathing problems
• glaucoma
• kidney
• liver diseases
• a history of excessive alcohol use
• a history of depression
• suicidal thoughts
• an addiction to drugs or alcohol

People should not take this medication if they:

• have narrow-angle glaucoma
• are also taking itraconazole (Sporanox) or ketoconazole (Nizoral)
• are allergic to Xanax or other benzodiazepines, such as:
  • chlordiazepoxide (Librium)
  • clorazepate (Tranxene)
  • diazepam (Valium)
  • lorazepam (Ativan)
  • oxazepam (Serax)

Other precautions

In certain individuals, the body may handle alprazolam differently. This includes people who:

• drink a lot of alcohol
• have alcoholic liver disease
• have impaired hepatic function
• have impaired renal function
• are older
• have obesity

Allergies

People should not use it if they are allergic to alprazolam or other benzodiazepines, such as:

• chlordiazepoxide (Librium)
• clorazepate (Tranxene)
• diazepam (Valium)
• lorazepam (Ativan)
• oxazepam (Serax)

Alcohol

People should not drink alcohol while taking alprazolam. It can increase the effects of alcohol.

Pregnancy

People should not use alprazolam if they are pregnant. Benzodiazepines can potentially cause harm to the fetus. During the first trimester, for example, alprazolam increases the risk of congenital abnormalities.

People should usually avoid taking Xanax during the first trimester of pregnancy.

Healthcare professionals should also inform people that if they become pregnant or intend to become pregnant while taking alprazolam, they should tell their doctor.

A child born of a person who is taking benzodiazepines may be at risk of withdrawal symptoms from the drug. Respiratory problems have also occurred in children born to people who have been taking benzodiazepines while pregnant.

Nursing

It may be excreted in human milk. As a general rule, people who use this medicine should not breastfeed.

Children

Researchers have not yet studied alprazolam use in children.

Gender

Gender does not affect the body’s response to this medicine.

Older adults

Older adults, or people aged 65 years and above, may be more sensitive to the effects of benzodiazepines. For example, the sedative effects of alprazolam may last longer in older adults.

Accidental falls are also common in older adults who take benzodiazepines. Therefore, people should use caution to prevent falling or accidental injury while taking alprazolam.

Race

It may affect Asian populations more than white populations.

Smoking

It concentrations may be reduced in up to 50% of people who smoke, compared with people who do not smoke.

Suicide

As with other psychotropic medications, there are some precautions to take when people with severe depression or suicidal thoughts take this drug.

Mania

Episodes of hypomania and mania have occurred in association with the use of alprazolam in people with depression.

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