Xanax

( Alprazolam )

Medically Reviewed by Harshi Dhingra, M.D.

Last Reviewed: Jun 22, 2022

Warnings

What are the risks of taking Xanax (alprazolam)?

Xanax can cause serious health problems, especially in certain high-risk groups.

Drowsiness and breathing difficulties: Xanax can cause severe drowsiness, confusion, tiredness, difficulty breathing, and even death. The risk is higher in people who are taking higher doses of Xanax or are on a longer duration of treatment, as well as in those who take opioid drugs or drink alcohol. In addition, people with chronic pain may be on opioid drugs. Talk to your healthcare provider about a safe combination of medications. If you have trouble waking up or breathing difficulties while on Xanax treatment, seek medical attention right away.
Dependence and withdrawal: Xanax can be habit-forming. People who take high doses of Xanax or are on this medication for a long time can develop physical and psychological dependence. Stopping Xanax suddenly can lead to withdrawal symptoms. Again, the risk of withdrawal is higher in people on a high dose of Xanax, long duration of treatment, and those who have a history of substance abuse or take Xanax with alcohol or recreational drugs. Do not take Xanax at higher doses or more frequently than prescribed. Do not stop taking Xanax without talking to your doctor first
Suicidal thoughts and behaviors: People taking Xanax should watch for signs of worsening depression, unusual mood changes, or suicidal thoughts or behaviors. Please seek immediate care from a medical professional if any emotional or behavioral changes occur.
Concentration: Xanax can make you drowsy and affect your focus and concentration. Be careful while doing activities that require full attention, such as driving or operating heavy machinery, until you know how Xanax affects you. This risk is higher if you take other medications that cause drowsiness or use recreational drugs or drink alcohol.
Drug interactions: Xanax is processed by the liver and can interact with other medications that are also processed by the liver. Be sure to give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal products.
Pregnancy: Taking Xanax while pregnant can cause harm to the unborn baby. Tell your doctor if you are pregnant, could be pregnant, plan to become pregnant, or are breastfeeding.

Your doctor can prescribe other medications to treat anxiety disorders and panic disorder if you are at high risk of Xanax complications.

What should I tell my doctor before starting Xanax (alprazolam)?

Tell your healthcare provider about all your medical conditions. Xanax may not be suitable for people with certain medical conditions like glaucoma (increased eye pressure), seizures, lung disease, kidney disease, or liver disease.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products, especially products containing St. John’s Wort. This can help avoid serious drug interactions and adverse effects.

Tell your doctor if you have previously had an allergic reaction to alprazolam, any active or inactive ingredients in Xanax preparations, or any other medication. Your pharmacy can provide you with a list of ingredients.

If you are over 65 years of age, talk to your doctor about the risks of taking Xanax. Your doctor may prescribe a lower dose of Xanax because higher doses can cause serious side effects in older individuals.

Xanax can be harmful to the unborn baby if it is taken during pregnancy. Before starting Xanax, tell your doctor if you are pregnant, could be pregnant, plan to become pregnant, or are breastfeeding.

What precautions should I take while on Xanax (alprazolam)?

Keep all your health care appointments while on Xanax treatment to ensure proper medical care. Your doctor may need to change your dose and monitor you carefully for side effects.

Xanax can make you drowsy and dizzy. Do not drive, operate heavy machinery, or do anything that requires focus and attention before knowing how this medicine affects you. Also, remember that drinking alcohol while on Xanax increases your risk of serious, potentially life-threatening side effects.

Please call your doctor if you become pregnant while on treatment with Xanax. This medicine can be harmful to the unborn baby.

Tell your healthcare providers you are on Xanax before undergoing any surgery, including dental surgery.

Get medical help immediately if you experience symptoms such as seizures, shortness of breath, yellowing of the skin or eyes, severe skin rash, confusion, speech problems, or problems with balance and coordination.

What are Xanax (alprazolam) interactions?

Taking Xanax with certain other medications can affect how well this medicine works. Drug interactions can also increase the risk of serious adverse effects. Your physician may choose a different anti-anxiety medication for you, change the dose or frequency of your medicines, and/or monitor you carefully for side effects if there are known interactions between Xanax and any of your other medicines.

Using Xanax with the following medications is not recommended:

itraconazole (Sporanox, Onmel)
ketoconazole (Nizoral)

There can also be interactions between Xanax and medicines such as:

certain heart medications (Pacerone, Cordarone, Cardizem, Cartia XT, Procardia, and others)
certain antidepressants or mood elevators (Tofranil, Norpramin, and others)
certain antifungals (Diflucan, Vfend, Noxafil)
certain antihistamines (Tagamet)
certain antibiotics (clarithromycin (Biaxin and in Prevpac), erythromycin)
cyclosporine (Neoral, Gengraf, Sandimmune)
ergotamine (Ergomar, Cafergot, Migergot)
isoniazid (Laniazid, Rifater, Rifamate)
certain medications for mental illness and seizures
oral contraceptives (birth control pills)
antidepressants (selective serotonin reuptake inhibitors (SSRIs like Prozac, Luvox, Paxil, and Zoloft)
sedatives, sleeping pills; and tranquilizers

This list does not describe all possible Xanax drug interactions. Give your healthcare provider a complete list of your medications, including prescription and non-prescription drugs, vitamins and dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with Xanax.

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