Alprazolam

Alprazolam Brand Names

Niravam | Xanax | Xanax XR

What is Alprazolam

Alprazolam is an oral benzodiazepine used for the treatment of anxiety disorders including panic disorder with or without agoraphobia and generalized anxiety disorder.

It is also used for the short term management of nonspecific anxiety.

Benzodiazepines may be used as sedatives, however, treatment options with less addiction potential should be considered prior to initiation of a benzodiazepine for this purpose.

Alprazolam is often preferable to other benzodiazepines, such as chlordiazepoxide, clorazepate, and flurazepam because alprazolam has a shorter half-life and metabolites with minimal activity.

However, alprazolam has a relatively high potential for abuse and if discontinuation becomes necessary, tapering of the drug may take weeks to months. Therefore, other short-acting, high-potency benzodiazepines without active metabolites such as lorazepam and oxazepam are preferred in most instances.

Like other triazolo benzodiazepines such as triazolam, alprazolam may have significant drug interactions involving the hepatic cytochrome P-450 3A4 isoenzyme.

Therefore, it should be used cautiously, if at all, with significant inhibitors of this metabolic pathway.

Alprazolam was approved by the FDA in 1981 and became available as a generic in 1993.

The extended-release formulation of alprazolam (Xanax XR) for treatment of panic disorder was granted approval by the FDA in January 2003.

In general, the precautions, side effects, and drug interactions are similar between the immediate-release and extended-release formulations of alprazolam.

On January 21, 2005, an orally disintegrating formulation of alprazolam (Niravam) was approved by the FDA for use in generalized anxiety disorder and panic disorder.

Indications

  • anxiety
  • generalized anxiety disorder (GAD)
  • panic disorder
  • premenstrual dysphoric disorder (PMDD)
  • premenstrual syndrome (PMS)

For the treatment of transient symptoms of anxiety, anxiety associated with depression, or generalized anxiety disorder (GAD)

Side Effects

  1. abdominal pain
  2. abnormal dreams
  3. agitation
  4. akathisia
  5. amnesia
  6. angioedema
  7. anorexia
  8. anxiety
  9. appetite stimulation
  10. arthralgia
  11. asthenia
  12. ataxia
  13. back pain
  14. blurred vision
  15. chest pain (unspecified)
  16. confusion
  17. constipation
  18. depression
  19. diaphoresis
  20. diarrhea
  21. diplopia
  22. dizziness
  23. drowsiness
  24. dysarthria
  25. dyskinesia
  26. dysmenorrhea
  27. dyspepsia
  28. dysphonia
  29. dyspnea
  30. dysuria
  31. edema
  32. elevated hepatic enzymes
  33. epistaxis
  34. euphoria
  35. fatigue
  36. fever
  37. galactorrhea
  38. gynecomastia
  39. hallucinations
  40. headache
  41. hepatic failure
  42. hepatitis
  43. hostility
  44. hot flashes
  45. hyperbilirubinemia
  46. hyperprolactinemia
  47. hypersalivation
  48. hyperventilation
  49. hypotension
  50. hypotonia
  51. impaired cognition
  52. impulse control symptoms
  53. infection
  54. influenza
  55. insomnia
  56. irritability
  57. jaundice
  58. lethargy
  59. libido decrease
  60. libido increase
  61. malaise
  62. mania
  63. memory impairment
  64. menstrual irregularity
  65. muscle cramps
  66. myalgia
  67. mydriasis
  68. nasal congestion
  69. nausea
  70. nightmares
  71. palpitations
  72. paresthesias
  73. peripheral edema
  74. photophobia
  75. physiological dependence
  76. pruritus
  77. psychological dependence
  78. psychomotor impairment
  79. rash
  80. rhinitis
  81. rhinorrhea
  82. seizures
  83. sinus tachycardia
  84. Stevens-Johnson syndrome
  85. syncope
  86. teratogenesis
  87. tinnitus
  88. tolerance
  89. tremor
  90. urinary incontinence
  91. urticaria
  92. vertigo
  93. vomiting
  94. weakness
  95. weight gain
  96. weight loss
  97. withdrawal
  98. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • anxiety
  • benzodiazepine dependence
  • benzodiazepine hypersensitivity
  • bipolar disorder
  • breast-feeding
  • children
  • chronic obstructive pulmonary disease (COPD)
  • closed-angle glaucoma
  • CNS depression
  • coadministration with other CNS depressants
  • coma
  • dementia
  • depression
  • driving or operating machinery
  • ethanol ingestion
  • ethanol intoxication
  • geriatric
  • hepatic disease
  • infants
  • labor
  • mania
  • myasthenia gravis
  • neonates
  • obesity
  • obstetric delivery
  • Parkinson’s disease
  • porphyria
  • pregnancy
  • psychosis
  • pulmonary disease
  • renal failure
  • renal impairment
  • respiratory depression
  • seizure disorder
  • seizures
  • shock
  • sleep apnea
  • status epilepticus
  • substance abuse
  • suicidal ideation

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alfentanil
  • Amiodarone
  • Amitriptyline; Chlordiazepoxide
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amprenavir
  • Apalutamide
  • Apomorphine
  • Apraclonidine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atracurium
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine
  • Azelastine; Fluticasone
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benztropine
  • Boceprevir
  • Bosentan
  • Brexpiprazole
  • Brimonidine
  • Brimonidine; Brinzolamide
  • Brimonidine; Timolol
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Caffeine
  • Caffeine; Ergotamine
  • Cannabidiol
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Cenobamate
  • Ceritinib
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloramphenicol
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorthalidone; Clonidine
  • Cimetidine
  • Ciprofloxacin
  • Cisapride
  • Cisatracurium
  • Clarithromycin
  • Clemastine
  • Clobazam
  • Clonazepam
  • Clonidine
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine; Probenecid
  • COMT inhibitors
  • Conivaptan
  • Crizotinib
  • Cyclizine
  • Cyclosporine
  • Cyproheptadine
  • Dalfopristin; Quinupristin
  • Danazol
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desflurane
  • Deutetrabenazine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Diazepam
  • Dicyclomine
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Disulfiram
  • Doxacurium
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Dronedarone
  • Droperidol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elbasvir; Grazoprevir
  • Elexacaftor; tezacaftor; ivacaftor
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enflurane
  • Enzalutamide
  • Ergotamine
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Esketamine
  • Eslicarbazepine
  • Estazolam
  • Eszopiclone
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethosuximide
  • Etomidate
  • Fedratinib
  • Felbamate
  • Fentanyl
  • Fluconazole
  • Flumazenil
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurazepam
  • Fluvoxamine
  • food
  • Fosamprenavir
  • Fospropofol
  • Gabapentin
  • General anesthetics
  • grapefruit juice
  • Green Tea
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guanabenz
  • Guanfacine
  • Haloperidol
  • Halothane
  • Homatropine; Hydrocodone
  • Hydantoins
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Indinavir
  • Isavuconazonium
  • Isoflurane
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ivacaftor
  • Ketamine
  • Ketoconazole
  • Lacosamide
  • Lamotrigine
  • Lasmiditan
  • Lefamulin
  • Letermovir
  • Levetiracetam
  • Levocetirizine
  • Levomethadyl
  • Levomilnacipran
  • Levorphanol
  • Lithium
  • Lofexidine
  • Lomitapide
  • Lopinavir; Ritonavir
  • Lorazepam
  • Loxapine
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Magnesium Salts
  • Maprotiline
  • Meclizine
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Meprobamate
  • Mestranol; Norethindrone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Methscopolamine
  • Methsuximide
  • Methyldopa
  • Metoclopramide
  • Metyrapone
  • Metyrosine
  • Midazolam
  • Mifepristone
  • Milnacipran
  • Minocycline
  • Mirtazapine
  • Mitotane
  • Mivacurium
  • Molindone
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Neuromuscular blockers
  • Nevirapine
  • Nicardipine
  • Nifedipine
  • Nilotinib
  • Nitroglycerin
  • Obeticholic Acid
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Oritavancin
  • Oxazepam
  • Oxcarbazepine
  • Oxybutynin
  • Oxycodone
  • Oxymorphone
  • Paliperidone
  • Pancuronium
  • Papaverine
  • Paroxetine
  • Pazopanib
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Phenobarbital
  • Phenothiazines
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Pimozide
  • Posaconazole
  • Pramipexole
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Pregabalin
  • Primidone
  • Probenecid
  • Procarbazine
  • Propofol
  • Propoxyphene
  • Quazepam
  • Quetiapine
  • Ramelteon
  • Ranolazine
  • Rapacuronium
  • Rasagiline
  • Remifentanil
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Risperidone
  • Ritonavir
  • Rocuronium
  • Ropinirole
  • Rotigotine
  • Rufinamide
  • Safinamide
  • Saquinavir
  • Scopolamine
  • Secobarbital
  • Sedating H1-blockers
  • Segesterone Acetate; Ethinyl Estradiol
  • Sertraline
  • Sevoflurane
  • Simeprevir
  • Sincalide
  • Skeletal Muscle Relaxants
  • Sodium Oxybate
  • St. John’s Wort, Hypericum perforatum
  • Streptogramins
  • Succinimides
  • Succinylcholine
  • Sufentanil
  • Suvorexant
  • Tapentadol
  • Tasimelteon
  • Teduglutide
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Temazepam
  • Tetrabenazine
  • Tezacaftor; Ivacaftor
  • Thalidomide
  • Theophylline, Aminophylline
  • Thiopental
  • Thiothixene
  • Tiagabine
  • Tipranavir
  • Tizanidine
  • tobacco
  • Topiramate
  • Tramadol
  • Trandolapril; Verapamil
  • Trazodone
  • Triazolam
  • Tricyclic antidepressants
  • Trihexyphenidyl
  • Trimethobenzamide
  • Triprolidine
  • Tubocurarine
  • Valerian, Valeriana officinalis
  • Valproic Acid, Divalproex Sodium
  • Vecuronium
  • Verapamil
  • Vigabatrin
  • Vilazodone
  • Voriconazole
  • Zafirlukast
  • Zaleplon
  • Zileuton
  • Ziprasidone
  • Zolpidem
  • Zonisamide
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top