Alprazolam

Why is this medicine prescribed?

Alprazolam is used to treat anxiety disorders and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Alprazolam is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain.

Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Alprazolam comes as a tablet, an extended-release tablet, a disintegrating tablet (tablet that dissolves quickly in the mouth), and a solution (liquid) to take by mouth. The tablet, disintegrating tablet, and solution are taken two to four times a day. The extended-release tablet is taken once daily, usually in the morning.

Take alprazolam exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Alprazolam oral solution comes with a specially marked syringe for measuring the dose. Ask your pharmacist if you have any questions about how much medication you should take or how to use the syringe.

To take the disintegrating tablet, open the blister pack with dry hands. Remove the tablet and immediately place it on your tongue. The tablet will dissolve and can be swallowed with saliva. If necessary, the disintegrating tablet can be taken with water.

Swallow the extended-release tablets whole; do not chew, crush, or break them.

Your doctor will probably start you on a low dose of alprazolam and gradually increase your dose, not more than once every 3 or 4 days.

What special precautions should I follow?

Before taking alprazolam,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• some medications should not be taken with alprazolam. Other medications may cause dosing changes or extra monitoring when taken with alprazolam. Make sure you have discussed any medications you are currently taking or plan to take before starting alprazolam with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking alprazolam, please get the advice of your doctor or pharmacist.
• the following nonprescription or herbal products may interact with alprazolam: allergy medications (diphenhydramine, loratadine, fexofenadine, chlorpheniramine or cetirizine), cimetidine or other antacids, or St. John's Wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking alprazolam. Do not start any of these medications while taking alprazolam without discussing with your healthcare provider
• tell your doctor if you have glaucoma (increased pressure in the eye that may cause loss of sight). Your doctor may tell you not to take alprazolam.
• tell your doctor if you have or have ever had seizures, lung or breathing problems, or kidney or liver disease.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant.  If you become pregnant while taking alprazolam, call your doctor. Alprazolam may harm the fetus.
• tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while you are taking alprazolam.
• you should know that alprazolam may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• this medication may not be recommended in people 65 years or older. There may be other treatment options that are safer or work better. Talk to your doctor about the risks and benefits of taking this medication.
• if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent damage to your brain that can cause severe intellectual disability), you should know that the disintegrating tablets contain aspartame that forms phenylalanine.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking alprazolam.

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit or drinking grapefruit juice while taking this medicine.

What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• drowsiness
• confusion
• problems with coordination
• loss of consciousness

What side effects can this medicine cause?

Alprazolam may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• light-headedness
• headache
• tiredness
• dizziness
• irritability
• talkativeness
• dry mouth
• increased salivation
• changes in sex drive or ability
• nausea
• constipation
• changes in appetite
• weight changes
• difficulty urinating
• joint pain

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

• shortness of breath
• seizures
• rash; hives; itching; swelling of the eyes, face, lips, tongue, or throat; difficulty breathing or swallowing; or hoarseness
• yellowing of the skin or eyes
• confusion
• problems with speech
• problems with coordination or balance

Alprazolam may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone ( 1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Discard any cotton in the bottle containing orally disintegrating tablets and close the bottle tightly.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Alprazolam is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.