Alprazolam oral tablets come in an immediate-release (IR) form that’s prescribed for generalized anxiety disorder (GAD) and panic disorder. They also come in an extended-release (ER) form that’s prescribed for panic disorder.
This article describes alprazolam oral tablets’ dosages and strengths and give details on how to take them. You’ll also find information on cost savings and coupon options for alprazolam. To learn more about alprazolam, talk with your doctor.
Alprazolam IR oral 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. But those forms aren’t described in this article. To learn more about those forms, talk with your doctor.
Alprazolam oral tablets have boxed warnings. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). For details, see the end of this article.
Need a diagnosis or prescription quickly? For certain health conditions, Optum Perks offers personalized on-demand care with no appointment required. For $25, answer a few questions online and receive a diagnosis and treatment plan from a board certified healthcare professional in 15 minutes or less. Get started here.
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
* “Immediate release” means the drug releases into your body right away after you take a dose.
† “Extended release” means the drug releases into your body slowly over time after you take a dose.
Dosage of alprazolam
This article describes the recommended dosages for alprazolam oral tablets. The drugmaker provides these recommended dosages. In some cases, doctors may adjust your dosage from those shown in the table later in the article.
If your doctor prescribes this medication, you should follow the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of alprazolam oral tablets without your doctor’s recommendation.
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 in the next section describes dosages of immediate-release (IR) and extended-release (ER) oral tablets that are commonly prescribed.
Alprazolam IR dosage for anxiety disorder and panic disorder
Here are the usual recommended dosages of alprazolam IR oral tablet for its approved uses.
| Condition | Starting dosage | Maintenance (ongoing) dosage | Maximum dosage |
|---|---|---|---|
| GAD | 0.25 to 0.5 mg taken 3 times per day | 0.75 to 4 mg per day, divided into 3 doses | 4 mg per day, divided into 3 doses |
| panic disorder | 0.5 mg taken 3 times per day | 1 to 10 mg per day, divided into 3 doses | 10 mg per day, divided into 3 doses |
Your doctor may adjust your dose every 3 to 4 days as needed.
If you need to stop taking alprazolam, your doctor will have you taper (slowly lower) your dosage to help prevent withdrawal symptoms. See the “Boxed warnings for alprazolam” section later for details.
Alprazolam ER dosage for panic disorder
Here are the usual recommended dosages of alprazolam ER oral tablet for its approved use. (The drugmaker does not provide an alprazolam ER dosage for GAD. The ER tablet is not approved for this condition.)
| Condition | Starting dosage | Maintenance dosage | Maximum dosage |
|---|---|---|---|
| panic disorder | 0.5 to 1 mg once per day | 3 to 6 mg once per day | 6 mg once per day* |
Your doctor may adjust your dose every 3 to 4 days as needed.
If you need to stop taking alprazolam, your doctor will have you taper (slowly lower) your dosage to help prevent withdrawal symptoms. See the “Boxed warnings for alprazolam” section later for details.
* 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
- other medications you’re taking
Alprazolam oral tablets have a boxed warning for risks when taken with opioids. (For more information, see the “Boxed warnings for alprazolam” section later in the article.) 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 tablets and avoid missing a dose, read this article. You could also try:
- downloading a reminder app on your phone
- setting an alarm
- putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table
Frequently asked questions
Here are the 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 and highest dose of alprazolam that doctors prescribe?
The lowest recommended starting dose of alprazolam immediate-release (IR) oral tablet is 0.25 milligrams (mg), taken three times per day (for a total of 0.75 mg per day). The highest recommended dose is a total of 10 mg per day.
The lowest recommended starting dose of alprazolam extended-release (ER) oral tablet is 0.50 mg once per day. The highest recommended dose is 6 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 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. 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 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 FDA is “alprazolam ER.” Alprazolam ER is the generic version of the brand-name drug Xanax XR. (For more, see this alprazolam vs. Xanax comparison.)
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 FDA-approved drug. In this case, verify with your doctor or pharmacist that you are given the correct medication.
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. In fact, alprazolam has boxed warnings about the risks of misuse, addiction, dependence, and withdrawal. These risks apply to people taking alprazolam short term or long term.
Boxed warnings are the most serious warning from the FDA. See “Boxed warnings for alprazolam” later in the article for more information.
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.
How alprazolam is taken
Alprazolam oral tablets are swallowed. You’ll take them up to three times per day. See the “Dosage of alprazolam” section for details about dose and frequency.
You can take immediate-release (IR) and extended-release (ER) tablets with or without food.
If needed, you can split alprazolam IR tablets, but you should not crush or chew them.
You should not crush, split, or chew alprazolam ER tablets. Instead, you’ll swallow them whole, preferably in the morning.
If it’s hard for you to swallow tablets, read these tips for how to swallow a pill. Also, be sure to talk with your doctor or pharmacist if you’re having difficulty taking your medication.
Alprazolam coupon
Visit this page to access Optum Perks coupons and get price estimates for alprazolam when you use the coupons. These coupons can provide significant savings on your prescription costs.
Note: Optum Perks coupons cannot be used with any insurance copays or benefits.
Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.
Free prescription coupons
Seriously … free. Explore prices that beat the competition 70% of the time.
Get free cardOverdose of alprazolam
It’s important that you do not take more alprazolam oral tablets than your doctor prescribes. Doing so can lead to harmful effects.
Symptoms of alprazolam overdose
Symptoms of a toxic dose can include:
- low blood pressure
- confusion
- problems with balance, coordination, or reflexes
- coma
- death, in rare cases
The amount of alprazolam that’s considered a lethal dose depends on whether other substances are taken with it. These substances might include alcohol or certain medications, such as opioids. Even a small dose of alprazolam taken with these substances can cause an overdose and be lethal.
What to do if you take too much alprazolam
If you think you’ve taken too much alprazolam, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.
Boxed warnings for alprazolam
This drug has boxed warnings about risks if it’s taken with opioids, as well as risks of misuse, addiction, dependence, and withdrawal. A boxed warning is the most serious warning from the FDA.
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. 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.
Before starting alprazolam, it’s important to let your doctor know if you have a substance use disorder. With this information and your medical history, your doctor can determine whether alprazolam is safe for you.
Risks if taken with opioids: Taking alprazolam or another benzodiazepine drug together with opioids increases the risk of severe side effects occurring. (Some examples of opioids are hydrocodone and oxycodone.) These side effects include:
- an inability to stay awake
- respiratory depression (severely slowed breathing)
- coma
In rare cases, taking alprazolam or another benzodiazepine drug with opioids can result in death.
Due to this risk, your doctor will likely 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.
Risk of misuse and addiction: Alprazolam has a risk of being misused. With misuse (also called abuse), a drug is taken in a way other than how it’s prescribed.
Misuse can increase the risk of becoming addicted to alprazolam. With addiction, you continue to take a drug even if it causes negative outcomes. Misuse of alprazolam also increases the risk of serious side effects and can cause overdose or death.
It’s important to take alprazolam exactly as your doctor prescribes it for you.
Risk of dependence and withdrawal: Alprazolam can cause dependence and withdrawal. Withdrawal describes symptoms that can occur when you stop taking a drug your body is dependent on. With dependence, your body needs the drug in order to function like usual.
Stopping alprazolam can also cause symptoms of anxiety or panic disorder to return, which can be similar to some withdrawal symptoms. Withdrawal symptoms can include:
- unusual movements that you can’t control
- anxiety or depression
- blurry vision
- dizziness
- depersonalization (a sense of unreality or feeling detached from yourself)
- nausea, vomiting, and diarrhea
- difficulty sleeping
- problems concentrating or thinking
- sensitivity to light or noise
- muscle pain, stiffness, twitching, or shaking
- tinnitus
In severe cases, withdrawal can be life threatening. Severe symptoms can include:
- hallucinations
- seizures
- shaking that you can’t control
- mania (periods of extreme excitement and energy)
- psychosis (loss of touch with reality)
- suicidal thoughts or behaviors
If you have thoughts of suicide during alprazolam treatment, call the Suicide and Crisis Lifeline by dialing or texting 988. Or tell your doctor right away. You can also refer to this article for ways to seek support.
If you need to stop alprazolam, your doctor will have you taper (gradually lower) your dosage. This helps prevent withdrawal symptoms. Do not stop taking alprazolam without your doctor’s approval and guidance.
Be sure to tell your doctor about any side effects you may be having while you’re tapering your alprazolam dosage or after you’ve stopped taking alprazolam.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.