Alprazolam oral tablets come in an immediate-release (IR) form that’s used for general anxiety disorder and panic disorder. They also come in an extended-release (ER) form that’s used for panic disorder.
This article describes alprazolam oral tablets’ dosages, their strengths, and details on how to take them. You’ll also find information on cost savings and coupon options for alprazolam.
Alprazolam IR tablet is a generic version of the brand-name drug Xanax. Alprazolam ER tablet is a generic version of the brand-name drug Xanax XR. Alprazolam also comes in other forms, including disintegrating tablets and oral liquid solutions, that aren’t described in this article. To learn more about these forms, talk with your doctor.
If you want to know more about alprazolam oral tablets, see this overview article. It covers details about the drugs’ uses, side effects, ways to save on cost, and more.
Boxed warning: Risks when taken with opioids
Alprazolam oral tablets have a boxed warning for risks when taken with opioids. Boxed warnings are serious warnings from the Food and Drug Administration (FDA). See the end of this article for more information.
Forms and strengths of alprazolam
Alprazolam oral tablets come as follows:
- immediate-release* (IR) tablets that you swallow:
- 0.25 milligrams (mg)
- 0.5 mg
- 1 mg
- 2 mg
- extended-release† (ER) tablets that you swallow:
- 0.5 mg
- 1 mg
- 2 mg
- 3 mg
* IR means the drug releases into the body right away after you take a dose.
† ER means the drug releases into the body slowly over time after you take a dose.
Dosage of alprazolam
This article describes the recommended dosages* for alprazolam oral tablets.
If your doctor prescribes this medication, they’ll determine the dosage that’s best for you. Do not change your dosage of alprazolam oral tablets without your doctor’s recommendation.
* The drugmaker provides these recommended dosages. If your doctor prescribes alprazolam oral tablets, be sure to take the dosage they prescribe for you.
Usual recommended dosages of alprazolam in adults
Usually, doctors start by prescribing a low dosage of alprazolam oral tablets. Then, they’ll adjust it over time until the right dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of alprazolam oral tablets that gives the desired outcome.
The information below describes dosages of immediate-release* (IR) and extended-release† (ER) tablets that are commonly prescribed. That said, always take the dosage your doctor prescribes for you. Your doctor will determine the dosage that best meets your needs.
* IR means the drug releases into the body right away after you take a dose.
† ER means the drug releases into the body slowly over time after you take a dose.
Alprazolam IR dosage for anxiety disorder and panic disorder
The table below summarizes dosages of alprazolam IR tablet for its approved uses. In the table, milligrams is abbreviated to “mg.”
| Condition | Starting dosage | Maintenance dosage | Maximum dosage |
| anxiety disorder | 0.25 mg to 0.5 mg 3 times per day | 0.75 mg to 4 mg per day, divided into 3 or 4 doses | 4 mg per day, divided into 3 or 4 doses |
| panic disorder | 0.5 mg 3 times per day | 1 mg to 10 mg per day, divided into 3 or 4 doses | 10 mg per day, divided into 3 or 4 doses |
Alprazolam ER dosage for panic disorder
The table below summarizes dosages of alprazolam ER tablet for its approved use. (The drugmaker does not provide an alprazolam ER dosage for anxiety. The ER tablet is not approved for this condition.)
| Condition | Starting dosage | Maintenance dosage | Maximum dosage |
| panic disorder | 0.5 mg to 1 mg once per day | 3 mg to 6 mg once per day | 6 mg once per day* |
* In rare situations, doctors may prescribe a dosage higher than 6 mg once per day to treat panic disorder.
Dosage adjustments for alprazolam
Your doctor will prescribe a dosage of alprazolam oral tablet based on several factors, including:
- the specific condition being treated and how severe it is
- your age
- other health conditions you may have
Alprazolam oral tablets have a boxed warning for risks when taken with opioids. Taking alprazolam or another benzodiazepine drug together with opioids increases your risk of severe side effects. (See “Boxed warning: Risks when taken with opioids” above for more information, including side effects.)
Because of this risk, doctors generally avoid prescribing alprazolam or other benzodiazepine drugs together with an opioid. This combination usually is prescribed only if other treatments don’t work or you’re unable to take them.
If your doctor does prescribe this combination, they’ll prescribe the lowest possible alprazolam dosage that treats your symptoms. They’ll also recommend taking alprazolam for the shortest time possible. In addition, they may lower your opioid dosage.
Missed dose of alprazolam
Talk with your doctor or pharmacist right away if you miss a dose of alprazolam oral tablets. They can advise whether you should take the missed dose. Or they can advise whether you should skip it and take your next dose as scheduled.
For tips on how to plan your doses of alprazolam oral tablets and avoid missing a dose, read this article. You could also try downloading a reminder app on your phone or setting an alarm.
Frequently asked questions
Below are answers to some commonly asked questions about alprazolam oral tablets and their dosage.
Is alprazolam prescribed as a muscle relaxant? If so, what’s the alprazolam muscle relaxant dosage?
No, alprazolam is not a muscle relaxant. Because this isn’t an approved use of the drug, the drugmaker hasn’t provided a recommended dosage.
Ask your doctor if you’d like information about muscle relaxant medications and their dosages.
What are the lowest dose and highest dose of alprazolam that doctors prescribe?
The lowest recommended starting dose of alprazolam is 0.25 milligrams (mg) taken three times per day. The highest recommended dose is a total of 10 mg per day. These dosages relate to specific uses of alprazolam. Your doctor will prescribe the lowest possible dosage that treats your symptoms.
Read the “Dosage of alprazolam” section above to learn about recommended alprazolam dosages for specific conditions. You can also learn more from your doctor or pharmacist.
Do doctors prescribe alprazolam for sleep? If they do, what is alprazolam’s dosage for sleep?
No, alprazolam is not approved for use as a sleep aid. The drug should not be taken for this purpose, so the drugmaker hasn’t provided a recommended dosage.
Ask your doctor if you’d like information about medications or other treatments approved for sleep conditions.
Is alprazolam XR the same as alprazolam ER?
No, alprazolam XR and alprazolam ER are not the same. The official name for alprazolam extended-release (ER) products approved by the Food and Drug Administration (FDA) is “alprazolam ER.” Alprazolam ER is the generic version of the brand-name drug Xanax XR.
For some drugs, “XR” also represents “extended release.” You may hear or see references to alprazolam ER as “alprazolam XR.” But alprazolam XR isn’t an approved drug. In this case, verify with your doctor or pharmacist that you are given the correct medication.
Alprazolam ER tablet is a controlled substance regulated by safety restrictions.* That means you need a prescription to obtain it. Only pharmacies that have been approved to dispense controlled substances can fill the prescription.
If you’re using an online pharmacy, you can verify its accreditation (approval). Check with the National Association of Boards of Pharmacy or your insurance company for assistance.
* Alprazolam immediate-release tablet is also a controlled substance.
Is alprazolam prescribed long term?
It depends. Doctors usually avoid prescribing alprazolam oral tablets as a long-term treatment. Instead, they’re usually recommended as a short-term treatment. But some people need to take alprazolam long term to manage their symptoms.
You and your doctor can determine whether it’s safe and effective for your condition. If you both feel it is, you can discuss the length of treatment that’s best for you.
Is there a risk of misuse, dependence, or withdrawal with alprazolam?
Yes, alprazolam carries risks of misuse, dependence, and withdrawal. These risks apply to people taking alprazolam short term or long term.
Misuse means using a drug in a manner other than how it’s prescribed. Misusing alprazolam can lead to serious or life threatening side effects, including difficulty breathing and coma. Because of these risks, alprazolam is classified as a controlled substance in the United States. This means it’s governed by special regulations to help prevent it from being misused.
Before starting alprazolam, it’s important to let your doctor know if you have a substance use disorder. This might include opioid use disorder (formerly called opioid abuse). With this information and your medical history, your doctor can determine whether alprazolam is safe for you.
Dependence means your body becomes used to having a drug to feel and function like usual. Withdrawal refers to having symptoms after stopping a drug on which your body is dependent. It’s crucial that you don’t stop taking alprazolam unless your doctor says it’s safe to do so.
If you’re considering stopping alprazolam, discuss doing so safely with your doctor. If you both agree you’ll stop taking it, your doctor will likely lower your dose slowly over time. This helps lessen your body’s dependence on alprazolam. It also lowers your risk of withdrawal symptoms. Do not stop taking alprazolam without first talking with your doctor.
