Specifically, the Food and Drug Administration (FDA) has approved Xanax to treat the following conditions in adults:
This article describes possible side effects of Xanax. You can explore this overview article to learn more about Xanax, including the drug’s uses, ways to save on cost, and more.
Xanax is a brand-name medication that comes as an oral tablet (Xanax) and an extended-release* oral tablet (Xanax XR).
A generic version of each tablet is also available. The generic version of Xanax is alprazolam; the generic version of Xanax XR is alprazolam XR.
This article describes possible side effects of both Xanax and Xanax XR. Throughout the article, “Xanax” refers to both forms. Where applicable, “Xanax XR” refers only to the extended-release oral tablet.
* “Extended release” means the drug is slowly released into your body over a long period of time.
Boxed warnings
Xanax has boxed warnings about the following risks. A boxed warning is the most serious warning from the FDA.
For details about the risk of serious harm if taken with opioids, see the “Side effects of Xanax in detail” section below. For more information about the other risks, see the “Withdrawal, dependence, misuse, and Xanax” section below.
More common side effects of Xanax
Xanax may cause mild or serious side effects. Below are some of the more common side effects of this medication.
Commonly reported side effects of Xanax include:
These side effects were reported in studies of Xanax and Xanax XR.
* To learn more about this side effect, see the “Side effects of Xanax in detail” section below.
Mild side effects of Xanax
Xanax may cause certain mild side effects. Usually, 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 Xanax that occurred in studies include:
These side effects were reported in studies of Xanax and Xanax XR. Xanax may cause more mild side effects than those listed above.
* To learn more about this side effect, see the “Side effects of Xanax in detail” section below.
† An allergic reaction is possible with Xanax and Xanax XR. It was reported in the drug’s studies for Xanax, but it wasn’t reported in the drug’s studies for Xanax XR.
Serious side effects of Xanax
Xanax may cause certain serious side effects. If you have any serious side effects from Xanax, 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 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 Xanax.
Serious side effects of Xanax that occurred in studies include:
These side effects were reported in studies of Xanax and Xanax XR.
* To learn more about this side effect, see the “Side effects of Xanax in detail” section below.
† Xanax and Xanax XR have a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the “Withdrawal, dependence, misuse, and Xanax” section below.
‡ An allergic reaction is possible with Xanax. It was reported in the drug’s studies for Xanax, but it wasn’t reported in the drug’s studies for Xanax XR.
Suicide prevention
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
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.
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Common questions about side effects of Xanax
Here are answers to some common questions about side effects of Xanax. If you have other questions, talk with your doctor or pharmacist.
Is Xanax safe for older adults?
Not necessarily. Guidelines from the American Geriatrics Society consider Xanax and other benzodiazepines to be potentially inappropriate medications for older adults (65 years and older).
In general, benzodiazepines, including Xanax, can increase the risk of certain problems in older adults, including:
In studies, older adults didn’t clear Xanax from their bodies as well as younger adults. This led to higher Xanax drug levels in the blood, which may increase the risk of side effects. For this reason, the recommended starting dosage of Xanax for older adults is usually lower than what’s prescribed for younger adults.
Talk with your doctor or pharmacist to learn more about how your age could affect your risk of side effects with Xanax.
How do side effects of Xanax seen in females compare with those seen in males?
Side effects reported in studies of Xanax and Xanax XR don’t seem to differ in females* compared with males.* The prescribing information doesn’t state whether some side effects are more common in females than males.
*Sex and gender exist on spectrums. In this article, we use the terms “male” and “female” to refer to a person’s sex assigned at birth.
Does Xanax cause long-term side effects?
Yes, in some cases Xanax may cause long-term side effects. These can occur if you take the drug for a long time.
Examples of long-term side effects reported with Xanax include:
These side effects were reported in studies of Xanax and Xanax XR.
Talk with your doctor to learn more about these side effects and how to manage them. Ask your doctor for more information about how long these side effects of Xanax may last.
*Xanax and Xanax XR have a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. To learn more, see the “Withdrawal, dependence, misuse, and Xanax” section below.
Withdrawal, dependence, misuse, and Xanax
Like other benzodiazepines, treatment with Xanax has a risk of misuse, addiction, dependence, and withdrawal. Both Xanax and Xanax XR have boxed warnings about these risks. A boxed warning is the most serious warning from the FDA.
Here are some quick definitions for these terms:
- With misuse, a drug is taken in a way other than how it’s prescribed.
- Addiction occurs when you continue misusing a drug despite it causing harm or wishing you could stop doing so.
- With dependence, your body needs the drug in order to function like usual.
- Withdrawal describes symptoms that can occur when you stop taking a drug your body is dependent on.
Misuse of benzodiazepines, including Xanax, can increase the risk of trouble breathing, coma, or death. These risks can go up when Xanax is combined with certain other medications or alcohol.
The risk of dependence and withdrawal goes up with higher daily dosages of Xanax and when it’s used for longer periods of time. Because Xanax can cause dependence, stopping it abruptly or lowering the dosage too fast can cause withdrawal.
Withdrawal symptoms after stopping Xanax range from mild to serious. Some examples include:
Some of these withdrawal reactions, such as seizures, can be life threatening. And sometimes withdrawal symptoms can last for several weeks or months. If you doctor recommends that you stop taking Xanax, they will lower your dosage slowly over time to reduce your risk of withdrawal symptoms. Do not abruptly stop taking Xanax unless your doctor tells you to do so.
Due to these risks, Xanax is a controlled substance in the United States. A controlled substance is a drug the government regulates due to the risk of misuse or dependence.
Side effects of Xanax in detail
Below you’ll find details on some of the side effects of Xanax.
Risk of serious harm if taken with opioids
Xanax and Xanax XR have a boxed warning about the risk of serious harm if taken with opioids (such as morphine or oxycodone). A boxed warning is the most serious warning from the FDA.
Both Xanax and opioid drugs can cause central nervous system (CNS) depression. Your CNS is made up of your brain and spinal cord. It coordinates activities throughout your body, including breathing.
With CNS depression, the activities controlled by the CNS are slowed down. Severe CNS depression can occur if Xanax is taken with an opioid. This can lead to serious or life threatening side effects, including trouble breathing, extreme sleepiness, coma, and death.
Certain factors can further increase the risk of harm if Xanax is taken with an opioid, such as adding alcohol or other CNS depressants, such as tranquilizers and sedatives. Risk may also go up with higher doses of Xanax or opioids, or when either of these medications are used for longer periods of time.
Note: Xanax also has a boxed warning about the risk of misuse, addiction, dependence, and withdrawal. To learn more, see the “Withdrawal, dependence, misuse, and Xanax” section above.
Ways to manage
If you have concerns about this warning, tell your doctor. Due to this risk, your doctor will avoid prescribing Xanax along with an opioid unless there are no other treatment options. If both medications are needed, your doctor will prescribe the lowest possible dose of each drug. They’ll also recommend that you take these drugs for the shortest duration needed to treat your conditions.
Your doctor will also monitor you for sleepiness, trouble breathing, and other signs and symptoms of CNS depression. You should also avoid driving or operating heavy machinery until you know how this combination affects you.
You or someone else should call 911 or go to the closest emergency room if you have symptoms that feel life threatening, such as excessive sleepiness or slowed or shallow breathing.
If you must take Xanax and an opioid, your doctor or pharmacist may also recommend having naloxone on hand. Naloxone can help treat severe breathing problems that could occur with this drug combination.
Sexual side effects
Sexual side effects were reported in studies of Xanax and Xanax XR. These side effects are usually mild, but they may be bothersome.
The sexual side effect that occurred most commonly in studies of Xanax was changes in libido (sex drive). Libido may be decreased or increased with Xanax.
Sexual difficulties also occurred in people taking Xanax and Xanax XR. Difficulties with sexual health may include the inability to have an orgasm, atypical ejaculation, and erectile dysfunction.
Certain factors can increase the risk of sexual side effects with Xanax. Anxiety can affect libido, and Xanax is prescribed to help treat certain anxiety disorders. Other factors can affect libido and sexual health as well, including stress, your age, and other health conditions you may have.
Ways to manage
If you experience sexual side effects, tell your doctor. They may recommend trying a lower Xanax dosage or discuss a different treatment. They may also ask questions to find out if the symptoms you’re having are due to the medication or another cause. Management will depend on the likely cause of your symptoms.
Dysarthria
Dysarthria (slurred speech) is a possible side effect of Xanax. This was one of the more common side effects in studies of Xanax and Xanax XR. This side effect may be mild or serious.
With dysarthria, you may have trouble saying words clearly. Or your speech may be slurred or slowed. This can occur if you have difficulty controlling the muscles used to speak.
Certain factors can increase the risk of dysarthria with Xanax. These include an overdose of Xanax, which can lead to CNS depression. But even usual doses of Xanax can lead to CNS depression and dysarthria.
Ways to manage
If you experience symptoms of dysarthria or have concerns about this possible side effect, tell your doctor. They may recommend trying a lower Xanax dosage. They may also suggest gradually stopping treatment and exploring other options for your condition.
Call 911 or go to the closest emergency room if you have symptoms that you feel may be life threatening. Sudden dysarthria can also be a sign of a stroke, which requires emergency care.
For some people, Xanax can cause an allergic reaction. This side effect was reported in the studies of Xanax, but it wasn’t reported in studies of Xanax XR.
Symptoms can be mild or serious and may include:
- itchiness
- skin rash
- swelling under the skin, usually affecting eyelids, lips, hands, or feet
- swelling of the mouth, tongue, or throat, which can make it hard to breathe
- flushing (temporary warmth, redness, or deepening of skin color)
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Xanax, your doctor may recommend taking a different medication instead.
Warnings for Xanax
Below are some factors you may want to discuss with your doctor before taking Xanax.
Boxed warnings
Xanax has boxed warnings about the risk of serious harm if taken with opioids (such as morphine or oxycodone), as well as the risk of misuse and addiction. It also has a boxed warning about the risk of dependence and withdrawal. A boxed warning is the most serious warning from the FDA.
For details about the risk of serious harm if taken with opioids, see the “Side effects of Xanax in detail” section above. For more information about the other risks, see the “Withdrawal, dependence, misuse and Xanax” section above.
Other warnings
It may not be safe for you to take Xanax if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether Xanax is a safe treatment option for you.
Before taking Xanax, tell your doctor about your health and medications you take. Things to consider include:
Xanax and pregnancy
Xanax should usually not be taken during pregnancy. Taking Xanax late in pregnancy can cause problems in the newborn, such as extreme sleepiness (including trouble breathing) or withdrawal symptoms.
If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with Xanax.
If you take Xanax during pregnancy, your doctor may advise you to join the drug’s pregnancy registry. This registry collects information about the risks and benefits of taking Xanax while pregnant. To learn more, talk with your doctor. You can also visit the registry website or call 866-961-2388.
Xanax and breastfeeding
Xanax should not be taken while breastfeeding. Xanax passes into breast milk and can cause extreme sleepiness and withdrawal symptoms in a breastfed child.
If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with Xanax.
Xanax is known to interact with alcohol. You should avoid consuming alcohol while you’re taking Xanax.
Consuming alcohol while taking Xanax raises your risk of CNS depression and possible life threatening side effects, including trouble breathing, extreme sleepiness, coma, and death. This risk can go up if you also take other medications that depress the CNS, such as opioids.
If you drink alcohol, talk with your doctor before you begin treatment with Xanax.
What to ask your doctor
This article describes common and serious side effects of Xanax. If your doctor prescribes this medication, they can discuss possible side effects with you. Let your doctor know if you have concerns or questions about treatment with this medication.
Here’s a list of questions you may want to ask your doctor:
- Are side effects of Xanax similar to those of other benzodiazepines, such as clonazepam?
- Am I at higher risk of side effects from Xanax based on my medical history?
- How can I lower my risk of side effects from Xanax?
- Are there other medications that could treat my condition that may have fewer side effects?
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.
