Specifically, the Food and Drug Administration (FDA) has approved alprazolam oral tablet to treat the following conditions in adults:
- generalized anxiety disorder
- symptoms of anxiety, for a short period of time
- panic disorder
This article describes possible side effects (also known as adverse effects) of alprazolam oral tablet. You’ll also find information on cost savings and coupon options for alprazolam.
Alprazolam oral tablet is a generic version of the brand-name drug Xanax. Alprazolam also comes in other forms taken by mouth, but these forms aren’t described in this article. To learn more about these forms, talk with your doctor.
You can explore this overview article to learn more about alprazolam oral tablet, including the drug’s uses, dosage, ways to save on cost, and more.
Boxed warnings
Alprazolam has a boxed warning about the risk of use with opioids. It also has boxed warnings about the risk of misuse, addiction, dependence, and withdrawal. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).
For details about the risk of use with opioids, see the “Side effects of alprazolam in detail” section below. To learn more about the risk of misuse, addiction, dependence, and withdrawal, see the “Withdrawal, dependence, misuse, and alprazolam” section below.
More common side effects of alprazolam
Alprazolam oral tablet may cause mild or serious side effects. Below are some of the more common side effects of this medication.
Commonly reported side effects of alprazolam oral tablet include:
- drowsiness
- fatigue (low energy)
- dizziness or lightheadedness
- difficulty with balance and coordination
- memory loss
Mild side effects of alprazolam
Alprazolam may cause certain mild side effects. Often, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.
Mild side effects of alprazolam oral tablet that occurred in studies include:
- difficulty with balance and coordination
- fatigue (low energy)
- difficulty concentrating
- memory loss
- drowsiness
- dizziness or lightheadedness
- difficulty speaking clearly
- headache
- dry mouth
- irritability
- changes in sex drive
- constipation
- nausea
- changes in appetite
- weight gain* or weight loss
- mild allergic reaction*
* To learn more about this side effect, see the “Side effects of alprazolam in detail” section below.
Alprazolam oral tablet may cause more mild side effects than those listed above. For details, see the drug’s prescribing information.
Serious side effects of alprazolam
Alprazolam may cause certain serious side effects. If you have any serious side effects from alprazolam oral tablet, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911, or a local emergency number, or go to the nearest emergency room.
After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with alprazolam oral tablet.
Serious side effects of alprazolam oral tablet that occurred in studies include:
- central nervous system (CNS) depression
- inability to safely perform dangerous activities that require coordination, such as driving or operating machinery
- depression, which may lead to thoughts of suicide
- depersonalization (feeling detached from yourself, such as if you’re in a dream or movie)
- blurry or double vision
- heart problems, including chest pain and irregular heartbeat
- liver problems, such as jaundice (yellowing of your skin or the whites of your eyes)
- movement problems, such as muscle tremors or uncontrolled muscle movements
- seizures
- hallucinations*
- risk of use with opioids†
- risk of misuse, addiction, dependence, and withdrawal‡
- severe allergic reaction*
* To learn more about this side effect, see the “Side effects of alprazolam in detail” section below.
† Alprazolam oral tablet has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects of alprazolam in detail” section below.
‡ Alprazolam oral tablet has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Withdrawal, dependence, misuse, and alprazolam” section below.
Suicide prevention
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Textline at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Common questions about side effects of alprazolam
Here are answers to some common questions about side effects of alprazolam oral tablet. If you have other questions, talk with your doctor or pharmacist.
How do side effects of alprazolam in older adults compare with those in younger adults?
Side effects caused by alprazolam are expected to be the same in younger and older adults. However, older adults are generally at higher risk for having side effects from alprazolam. (Older adults generally refers to people ages 65 years and older.)
Specifically, older adults have a higher risk for the following side effects of alprazolam:
- difficulty with balance and coordination
- memory loss
- difficulty concentrating
- drowsiness
Older adults who have drowsiness or coordination problems are at increased risk for falls.
Because of these risks, doctors typically prescribe a lower alprazolam dosage to adults ages 65 years and older. This helps reduce their risk for side effects. Doctors may also closely monitor older adults for side effects during alprazolam treatment.
Do different strengths of alprazolam, including 0.5 mg, 0.25 mg, and 1 mg, cause different side effects?
No, different alprazolam strengths do not cause different side effects. Alprazolam strengths are written in milligrams (mg).
That said, the risk of having side effects from alprazolam can vary with different dosages. For example, taking a higher dose is more likely to cause dependence* compared with taking a lower dose.
Talk with your doctor or pharmacist if you’d like to know more about your risk of side effects based on your alprazolam dosage.
* Alprazolam oral tablet has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Withdrawal, dependence, misuse, and alprazolam” section below.
Can alprazolam cause kidney-related side effects?
No, it’s not likely. Kidney-related side effects weren’t reported in alprazolam’s studies. The drug isn’t known to cause these side effects.
However, if you have kidney problems, you may have a higher risk for side effects from alprazolam. This is because your body relies on your kidneys to clear alprazolam after you take a dose. If you have a kidney problem, such as chronic kidney disease, the level of alprazolam in your body may become too high.
If you’d like to know more about alprazolam and kidney issues, ask your doctor or pharmacist.
If I take alprazolam with melatonin, will I experience certain side effects?
Taking alprazolam with melatonin can cause certain side effects. Combining the two can raise your risk of central nervous system (CNS) depression and drowsiness, as well as other side effects.
Due to this risk, your doctor or pharmacist may recommend that you don’t take melatonin with alprazolam.
Be sure to tell your doctor and pharmacist about all medications you take, including any over-the-counter drugs. You should also mention any supplements you take, including melatonin. Your pharmacist and doctor can check to see whether any of them interact with alprazolam.
Does alprazolam cause long-term side effects?
Yes, alprazolam can cause long-term side effects, although they’re rare.
Long-term side effects reported with alprazolam include:
- weight changes
- liver problems
- inability to safely perform dangerous activities that require coordination, such as driving or operating machinery
- depression, which may lead to thoughts of suicide
- depersonalization (feeling detached from yourself, such as if you’re in a dream or movie)
- risk of misuse, addiction, dependence, and withdrawal*
These side effects may occur at any point while you’re taking alprazolam, even if you’ve taken it for a long time without any problems. The side effects may also linger after you stop taking alprazolam.
Talk with your doctor or pharmacist if you have more questions about alprazolam and long-term side effects.
* Alprazolam oral tablet has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Withdrawal, dependence, misuse, and alprazolam” section below.
Withdrawal, dependence, misuse, and alprazolam
Alprazolam has a boxed warning about the risk of misuse, addiction, dependence, and withdrawal. Boxed warnings are serious warnings from the Food and Drug Administration (FDA). These risks are described below.
Alprazolam also has a boxed warning about the risk of use with opioids. To learn more about this risk, see the “Side effects of alprazolam in detail” section below.
Alprazolam and risk of misuse and addiction
Alprazolam carries a risk of misuse. Misuse means a drug is taken in a way other than how it’s prescribed. For example, taking a drug to get “high” is considered misuse.
Misusing alprazolam can also lead to addiction, which may involve any of the following:
- continuing to take a drug even if doing so causes harmful outcomes
- being unable to stop taking the drug
- neglecting work, school, or social obligations because of the drug
It’s important to note that drug addiction is different from drug dependence. To learn more, see below.
Misusing alprazolam can result in serious central nervous system (CNS) depression. The CNS consists of your brain and spinal cord and controls many activities in your body.
CNS depression can lead to:
- slowed heart rate
- difficulty breathing
- coma
CNS depression can cause other serious side effects, and it may even be fatal in rare cases. Taking alprazolam together with other medications that depress your CNS raises the risk of serious CNS depression.
Due to these risks, alprazolam is a controlled substance in the United States. This means that healthcare professionals must follow strict guidelines and regulations from federal and state governments to help prevent misuse of the drug.
Talk with your doctor if you have questions or concerns about alprazolam and misuse or addiction. If you have symptoms of CNS depression, you or someone else should immediately call 911 or your local emergency number.
Alprazolam and risk of dependence and withdrawal
Taking alprazolam can result in drug dependence. With dependence, your body needs a drug to function like usual. It’s possible to be dependent on a drug without being addicted to it.
Because alprazolam can cause dependence, stopping treatment with the drug can cause withdrawal symptoms. These are side effects that occur when you stop taking a drug your body is dependent on.
Withdrawal symptoms from alprazolam can be mild or serious. Some examples include:
- seizures
- difficulty concentrating
- muscle cramps
- blurred vision
- diarrhea
- insomnia (trouble sleeping)
- appetite loss
Due to this risk, you should not stop taking alprazolam unless your doctor specifically advises doing so. Also, do not change your alprazolam dosage or take the medication in any way that differs from your doctor’s instructions. Missing doses of the drug can also result in withdrawal symptoms.
If your doctor recommends that you stop treatment with alprazolam, they’ll recommend slowly decreasing your dosage over time. This is known as drug tapering. It can help lower your risk of withdrawal symptoms when you stop taking alprazolam.
Talk with your doctor if you have questions or concerns about alprazolam and dependence or withdrawal.
