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Alprazolam

Medical and Pharmacy Editor:

Brand Name: Niravam, Xanax, Xanax XR

Generic Name: alprazolam

Drug Class: Antianxiety Agents; Anxiolytics, Benzodiazepines

What Is Alprazolam (Xanax) and How Does It Work?

Alprazolam is a prescription medication indicated for the treatment of anxiety disorder (a condition corresponding most closely to the APA Diagnostic and Statistical Manual [DSM-III-R] diagnosis of generalized anxiety disorder), or the short-term relief of symptoms of anxiety. Generalized anxiety disorder (also anxiety) is characterized by unrealistic or excessive anxiety and worry over circumstances of life for a period of time. Anxiety or tension problems associated with the stress of everyday life usually do not require treatment with this drug. Alprazolam tablets are also indicated for the treatment of panic disorder, with or without agoraphobia. This drug is also used as a treatment for anxiety associated with depression.

Alprazolam belongs to a class of medications called benzodiazepines. Benzodiazepines are medications that have anti-anxiety producing properties.

This medication must be prescribed by a doctor and is available by prescription only.

This medication should not be used by patients who are pregnant. Use of this drug may affect the health of the baby.

Patients taking this drug or other benzodiazepines should not consume alcohol.

This drug may be habit-forming and has the potential to cause extreme dependence or abuse in some patients.

Side effects that are most commonly associated with this drug are drowsiness and lightheadedness.

Patients taking this drug should alert their doctors about any problems from the use of this medication and any troublesome side effects.

Read the information leaflet that accompanies the prescription as well as every time the prescription is refilled. There may be new health information.

Alprazolam is available under the following different brand names: Xanax, Niravam, and Xanax XR.

Dosages of Alprazolam (Xanax) Should Be Given As Follows:

Adult Dosage Forms & Strengths

Tablet: Schedule IV

  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg

Tablet, extended-release: Schedule IV

  • 0.5 mg
  • 1 mg
  • 2 mg
  • 3 mg

Tablet, orally disintegrating: Schedule IV

  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg

Oral solution: Schedule IV

  • 1 mg/mL

Dosage Considerations of Alprazolam (Xanax)

  • Treatment of Anxiety and Anxiety Disorders
    • 0.25-0.5 mg orally once every 6-8 hours
    • titrate dosage to effect once ever 3-4 days; not to exceed 4 mg/day

Panic Disorder Treatment (Panic and Anxiety Attacks)

  • Immediate-release
    • 0.5 mg orally once every 8 hours; may adjust once every 3-4 days by 1 mg or less/day
    • Average drug dose: 5-6 mg/day orally
    • May require up to 10 mg/day orally divided once every 8 hours

Extended-release

  • Dose drug 0.5-1 mg orally once/day; may adjust once every 3-4 days by 1 mg or less/day
  • Average drug dose: 3-6 mg orally once/day

Treatment for Anxiety Associated With Depression

  • Immediate-release: Decrease initial dose to 0.25 mg orally once every 8-12 hours
  • Extended-release: 0.5 mg orally once/day

Treatment of Premenstrual Syndrome (Off-label)

  • 0.25 mg orally once every 6-12 hours; initiate treatment on day 16-18 of menses (not to exceed 3-4 mg/day); taper dose over 2-3 days once menses occurs

Dosing Modifications

Renal impairment

  • Use caution; not studied

Advanced hepatic impairment

  • Immediate-release
    • Decrease initial dose to 0.25 mg orally once every 8-12 hours
    • Extended-release: 0.5 mg orally once/day

Not recommended for use in patients 18 years and younger.

Treatment of Geriatric Dose Panic Disorder

  • Immediate-release:
    • Decrease initial dose of medication to 0.25 mg orally once every 8-12 hours; may gradually increase if necessary and as tolerated; may increase every 3-4 days by 1 mg or less/day to 5-6 mg/day average dose
  • Extended-release:
    • Start at 0.5 mg orally once/day; may gradually increase if necessary and as tolerated; may increase once every 3-4 days by 1 mg or less/day to 3-6 mg/day

Geriatric Dose Anxiety Associated With Depression

  • Decrease initial dose of medication to 0.25 mg orally once every 8-12 hours; may gradually increase if needed and as tolerated; may increase every 3-4 days by 1 mg or less/day to 1-4 mg/day
  • Maintenance
    • 1-4 mg/day orally divided once every 8 hours

Geriatric Dosing Considerations

  • Use smallest dose of this drug to avoid ataxia and over-sedation and other undesirable side effects or symptoms
  • Elderly people are especially sensitive to benzodiazepines; higher plasma levels exhibited because of reduced clearance
  • Mean half-life: 16.3 hours in healthy elderly individuals (range: 9-26.9 hour), compared with 11 hours in healthy adults (range: 6.3-15.8 hour)
Medically Reviewed by a Doctor on 4/14/2017



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