Alprazolam (Xanax).

Brand Name:

  • Xanax®
  • Xanax XR®
  • Niravam®
  • Alprazolam Intensol®

Generic Name: Alprazolam

Physical Description:

  • Xanax®
    • Tablets .25mg – white oval with “XANAX 0.25” imprinted on it.
    • Tablets .5mg – orange oval with “XANAX 0.5” imprinted on it.
    • Tablets 1mg – blue oval with “XANAX 1.0” imprinted on it.
    • Tablets 2mg – white rectangle with “XANAX” on one side and “2” on the
    • other.
  • Xanax XR®
    • Extended-release tablets .5mg – white hexagon with “x” imprinted on one
    • side and “0.5” on the other.
    • Extended-release tablets 1mg – yellow square with “x” imprinted on one
    • side and “1” on the other.
    • Extended-release tablets 2mg – blue circle with “x” imprinted on one side
    • and “2” on the other.
    • Extended-release tablets 3mg – green triangle with “x” imprinted on one
    • side and “3” on the other.
  • Niravam®
    • Tablets .25mg – yellow circle with “SP 321” imprinted on one side and
    • “0.25” on the other.
    • Tablets .5mg – yellow circle with “SP 322” imprinted on one side and “0.5”
    • on the other.
    • Tablets 1mg – white circle with “SP 323” imprinted on one side and “1” on
    • the other.
    • Tablets 2mg – white circle with “SP 324” imprinted on one side and “2” on
    • the other.
  • Alprazolam Intensol®
    • Liquid (concentrate)

Black Box Warning

Alprazolam DOES have a Black Box warning that all patients should review before starting this medication. Alprazolam and its brand-name equivalents, when used in combination with opioid medications or other medications with sedative effects can lead to slowed respiration, difficulty breathing, and death. Additionally, Alprazolam is a benzobdiazepine, which is a class of drugs known to carry a risk of abuse, misuse, and addiction. It is possible to develop a physical dependence, and withdrawal from Alprazolam could result in the onset of withdrawal symptoms.

If you or a loved one is showing signs of abuse, misuse, or physical dependence, contact a healthcare provider immediately.

Side Effects

Like most medications, Alprazolam can produce side effects. Some side effects are more common while others may be more rare or serious.

Common Side Effects

  • Dizziness
  • Drowsy
  • Lightheaded
  • Fatigued
  • Reduced coordination
  • Difficulty concentrating

Rare/Serious Side Effects

  • Shortness of breath
  • Difficulty speaking
  • Increased heart rate
  • Headaches
  • Irritability
  • Restlessness
  • Allergic reactions (swelling)
  • Sleepwalking
  • Depression

Overdose Indications

Overdose on Alprazolam is more likely to occur when combined with opioids or other sedative drugs. Dizziness, sleepiness, trouble breathing, confusion, impaired coordination, slow reflexes, and lack of consciousness are all indications of a potential overdose and require immediate medical attention.

FDA Approved to Treat

Generalized Anxiety Disorder (GAD)

Panic Disorder

Off-Label Usage

The most common off-label use of Alprazolam is for Depression. However, it has been known to be used to treat an array of mental health conditions, including palliative sedation, geriatric agitation, movement disorders, seizure disorders, traumatic brain injuries, pain, tinnitus, and addiction.


Alprazolam is administered as a tablet or liquid to be taken by mouth. Tablets are not to be chewed, crushed, or split.

Dosage varies greatly from one case to another and providers will prescribe a specific dose based on individual needs. Dose instructions may be to take your medication at regular intervals or on an as-needed basis (“PRN”).

While it is not required, taking your medication with food can help prevent an upset stomach.

Missed Dose

If you miss a dose, take it as soon as you remember unless it is close to your next dose. Do not double your dose or take more than what is prescribed. Inform your healthcare provider if you miss a dose.


Your doctor may not prescribe Alprazolam if you have a known allergy to the medication, if you are taking another medication with a known interaction, if you have glaucoma, if you have experienced seizures, lung, kidney, or liver disease, or if you are pregnant or breastfeeding.

Medication Interactions

Ketoconazole (Nizoral®), itraconazole (Sporanox®), nefazodone (Serzone®), fluvoxamine (Luvox®), and cimetidine (Tagamet®) are known to increase the effects of Alprazolam. Carbamazepine (Tegretol®), phenytoin (Dilantin®), and phenobarbital (Luminal®) on the other hand will decrease the effects of Alprazolam..

Additional medications that should not be combined with Alprazolam include:

  • Antihistamines
  • Narcotics
  • Opioid-based drugs
  • Sleep-aids
  • Other anti-anxiety medications
  • Antipsychotics
  • Certain anticonvulsants
  • Tricyclic antidepressants

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