Xanax, Xanax XR, Alprazolam Intensol

Alprazolam (al PRAY zoe lam) oral tablet is prescribed for anxiety disorder and panic disorder in adults. It’s a generic version of the brand-name drug Xanax. Alprazolam belongs to a group of drugs called benzodiazepines.

Medically reviewed by Dana Kim, PharmD on April 16, 2023
Written by Alex Brewer, PharmD, MBA

Introduction

This article describes alprazolam oral tablet’s uses and dosage, ways to save on cost, and more. Below you’ll find coupon options for alprazolam.

This article doesn’t describe or provide coupons for all forms of alprazolam, only the immediate-release oral tablet form. To find out more about alprazolam’s other forms, see the following articles:

• alprazolam ER
• alprazolam XR
• alprazolam ODT
• alprazolam intensol

Boxed warnings

Alprazolam has boxed warnings about the risks of dependence, withdrawal, misuse, and addiction. It also has a boxed warning about the risk of serious harm if taken with opioids. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

For more information about the risks of dependence, withdrawal, misuse, and addiction, see the “Misuse, dependence, or withdrawal of alprazolam” section below. For details about the risk of serious harm if taken with opioids, see the “Warnings for alprazolam” section below.

Side effects of alprazolam

Alprazolam may cause mild or serious side effects (also known as adverse effects). More common mild side effects of alprazolam oral tablet and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about alprazolam oral tablet’s side effects, see this article or ask your doctor or pharmacist. You can also read the prescribing information for alprazolam oral tablet.

Mild side effects

More common mild side effects reported with alprazolam oral tablet are listed below.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Alprazolam oral tablet’s mild side effects include:

• trouble concentrating
• drowsiness
• fatigue (low energy)
• feeling dizzy or lightheaded
• irritability
• headache
• memory loss
• problems with balance and coordination
• trouble speaking clearly
• mild allergic reaction*

* For details about this side effect, see the “Warnings for alprazolam” section below.

These are not all the possible mild side effects alprazolam may cause. Talk with your doctor or pharmacist to learn more about other side effects, or check out the drug’s full prescribing information.

Serious side effects

Serious side effects of alprazolam oral tablet are listed below. With many drugs, serious side effects are possible but not common.

If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

Alprazolam oral tablet’s serious side effects include:

• blurry or double vision
• central nervous system depression
• depersonalization (feeling detached from yourself, such as feeling as if you’re in a dream or movie)
• depression
• hallucinations (seeing or hearing things that aren’t really there)
• heart problems, including chest pain and irregular heartbeat
• inability to safely perform activities that require coordination, such as driving or operating machinery
• 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
• seizure
• boxed warning: risk of dependence and withdrawal*
• boxed warning: risk of misuse and addiction*
• boxed warning: risk of serious harm if taken with opioids†
• severe allergic reaction†

* For details about this side effect, see the “Misuse, dependence, or withdrawal of alprazolam” section below.
† For details about this side effect, see the “Warnings for 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.

Uses of alprazolam

The Food and Drug Administration (FDA) approves prescription drugs such as alprazolam for certain conditions. Approved uses for alprazolam oral tablet are described below.

Use for anxiety

Doctors may prescribe alprazolam oral tablet for treating generalized anxiety disorder (GAD), often just called anxiety. It’s used for this purpose in adults as a short-term or long-term treatment.

With GAD, you experience excessive anxiety that lasts for several months. This results in symptoms including:

• fatigue (low energy)
• irritability
• trouble concentrating
• insomnia (trouble sleeping)

Most people can feel anxious from time to time. But for people with GAD, the worrying is excessive and doesn’t go away. It can affect day-to-day activities such as work or school.

Use for panic disorder

Doctors may prescribe alprazolam oral tablet for treating panic disorder. It’s used for this purpose in adults as a short-term or long-term treatment.

With panic disorder, you experience unexpected, recurring panic attacks. A panic attack is a short episode of sudden, intense terror or fear. Physical symptoms of a panic attack include trouble breathing, fast heartbeat, and excessive sweating.

Common questions about alprazolam

Below you’ll find answers to a few commonly asked questions about alprazolam oral tablet.

Can alprazolam be used for sleep, depression, or tinnitus?

Alprazolam is not approved to treat sleep problems, depression, or tinnitus (ringing in the ears). The drug is approved to treat anxiety disorder and panic disorder in adults. For more details, see the “Uses of alprazolam” section above.

However, the drug may still be prescribed off-label for other uses. With off-label use, a drug is prescribed to treat a condition other than its approved uses.

If you have questions about what drugs can be used for sleep problems, depression, or tinnitus, talk with your doctor.

How does alprazolam compare with other similar drugs, such as diazepam?

Similar to alprazolam, Xanax and diazepam (Valium) belong to the same group of drugs called benzodiazepines. Benzodiazepines are used to treat conditions such as anxiety and insomnia (trouble sleeping). Benzodiazepines also include lorazepam (Ativan) and bromazepam.*

If you have questions about how alprazolam compares with other drugs, talk with your doctor or pharmacist.

* Bromazepam is not approved for use in the United States. It’s approved for use in the European Union, Canada, the United Kingdom, and some other countries. For more information, talk with your doctor.

What is alprazolam’s half-life? And how does the drug work?

Alprazolam has a half-life of about 11 hours, but this can depend on certain factors. A drug’s half-life describes how long it takes your body to clear half a dose of the medication.

Alprazolam is a type of drug called a benzodiazepine. It works by attaching to gamma-aminobutyric acid (GABA) receptors (a type of protein) in your brain. When alprazolam binds to GABA receptors, it sends signals to slow down your central nervous system. This can help treat or prevent symptoms of certain conditions, such as anxiety and panic disorder.

Some people may notice the effects of the drug right away while others may feel it 30 minutes after taking the dose. If you’re prescribed alprazolam and wondering how long it takes to work, talk with your doctor or pharmacist.

Does alprazolam cause different side effects in older adults?

No, alprazolam isn’t expected to cause different side effects in older adults (ages 65 years and older). But older adults have a higher risk of side effects from alprazolam. These include:

• trouble concentrating
• drowsiness
• memory loss
• problems with balance and coordination

Older adults have an increased risk of side effects. So they may have a higher risk of falls if they experience drowsiness or coordination problems due to alprazolam treatment.

If you’re an older adult, your doctor will likely prescribe a lower dose of alprazolam. And they’ll monitor you more closely for side effects from the drug. Talk with your doctor if you have questions about this.

Is there a best time of day to take alprazolam? What should I do if I miss a dose of the drug?

No, there’s no best time of day to take alprazolam. Take your dose as your doctor advises.

If you miss a scheduled dose of alprazolam, take it as soon as you remember. But if it’s nearly time for your next dose, skip the missed dose. Take the next dose at the scheduled time. Do not take more than one dose of alprazolam at once.

Talk with your doctor if you have questions about when to take your dose of alprazolam. 

Can alprazolam tablets be crushed, split, or chewed?

Certain alprazolam tablets come scored and may be split along the scoring marks in the tablets. In general, you should not crush or chew the tablets.

Talk with your pharmacist or doctor if you’re having trouble swallowing alprazolam tablets. You can also view this article for tips.

Dosage of alprazolam

The dosage of alprazolam oral tablet your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

Taking alprazolam

Alprazolam oral tablet is swallowed. It can be taken with or without food.

Your doctor will talk with you about how to take alprazolam oral tablet. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

See the “Common questions about alprazolam” section for information on missed doses and the best time to take this drug.

Overdose of alprazolam

You should not take more alprazolam than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

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 concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Interactions of alprazolam

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take alprazolam, ask your doctor to check for possible interactions. They can check for interactions these items may cause with alprazolam. Be sure to tell them about any of the following you take or use:

• prescription medications
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for alprazolam” section below.

Misuse, withdrawal, or dependence of alprazolam

Alprazolam has boxed warnings about the risks of dependence, withdrawal, misuse, and addiction.

Boxed warnings are serious warnings from the Food and Drug Administration (FDA). These warnings are discussed in more detail below.

Alprazolam and the risk of misuse or addiction

There’s a risk of misuse with alprazolam. With misuse, a drug is used in a way other than how it’s prescribed. An example of drug misuse is taking a drug to get “high”.

Misusing alprazolam can cause serious central nervous system (CNS) depression. The CNS is made of your brain and spinal cord and controls many activities throughout your body. Serious CNS depression can cause seizures, trouble breathing, coma, and other severe side effects. It can even be fatal in rare cases.

This risk is further increased if alprazolam is taken or misused along with other drugs that depress your CNS. These include opioids, such as oxycodone (OxyContin), or antihistamines, such as diphenhydramine (Benadryl).

Alprazolam misuse can cause addiction to the drug. With drug addiction, you continue using a drug despite negative consequences, such as neglecting work or personal relationships. You may not be able to stop taking the drug despite wanting to do so.

Because of these risks, alprazolam is a controlled substance in the United States. Healthcare professionals must follow strict guidance from federal and state governments when prescribing and dispensing controlled substances to help prevent drug misuse and addiction.

If you have questions or concerns about alprazolam and the risk of misuse or addiction, talk with your doctor. It’s important to note that addiction is different from drug dependence. See “Alprazolam and the risk of dependence and withdrawal” below to learn more.

Alprazolam and the risk of dependence and withdrawal

Taking alprazolam can cause drug dependence even when it’s taken as prescribed. With dependence, your body needs a drug in your system in order to feel and function as usual. Drug dependence is not the same as drug addiction. It’s possible to be dependent on a drug but not addicted to it.

Suddenly stopping alprazolam can cause withdrawal symptoms. Withdrawal symptoms are side effects that happen when you stop taking a drug your body is dependent on. They can be mild or serious and include:

• appetite loss
• blurred vision
• diarrhea
• trouble concentrating
• insomnia (trouble sleeping)
• muscle cramps 
• seizures

Due to the risk of withdrawal, it’s important that you do not stop taking alprazolam without first talking with your doctor. You also should not change your alprazolam dose on your own. And you should not take the medication in a way that is different than how your doctor advises.

If you and your doctor agree that you’ll stop taking alprazolam, your doctor will suggest a plan to taper (slowly lower) your dose over time. This will help reduce the risk of withdrawal symptoms when stopping alprazolam treatment.

Talk with your doctor if you have questions about alprazolam and the risk of dependence and withdrawal.

Alprazolam coupon

You may be able to save money on your prescription for alprazolam oral tablet by using our Perks discount coupons. These can be found at the end of this article.

If you have questions about how to pay for alprazolam, talk with your doctor or pharmacist. You can also learn more about the price of alprazolam in this article.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Warnings for alprazolam

Alprazolam should not be taken by certain people. And it some people should take this drug cautiously. Precautions for taking this drug are described below.

Boxed warnings

Alprazolam has boxed warnings about the risks of dependence, withdrawal, misuse, and addiction. It also has a boxed warning about the risk of serious harm if taken with opioids. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

To learn more about these warnings, read below. You can also talk with your doctor or pharmacist.

Risk of dependence and withdrawal. For details, see the “Misuse, dependence, or withdrawal of alprazolam” section above.

Risk of misuse and addiction. For details, see the “Misuse, dependence, or withdrawal of alprazolam” section above.

Risk of serious harm if taken with opioids. Alprazolam and opioid drugs both work to depress your central nervous system (CNS). The CNS is made up of your brain and spinal cord and controls many activities in your body. CNS depression due to taking alprazolam with an opioid can result in severely slowed breathing, coma, and other serious side effects. It can even result in a life threatening overdose.

If you think you’re having symptoms of CNS depression after taking alprazolam and an opioid together, immediately contact 911 (or your local emergency number). Or seek emergency medical help, such as the closest emergency room.

Examples of opioid medications include:

• strong prescription pain relievers, such as codeine, fentanyl (Actiq, Fentora, others), hydrocodone (Hysingla ER), and oxycodone (OxyContin)
• certain medications for treating opioid use disorder, including buprenorphine (BuTrans, others) and methadone (Methadose)

Due to the risk of severe side effects, your doctor will avoid prescribing alprazolam and an opioid together, unless there are no other treatment options suitable for you. If your doctor determines you’ll need to take alprazolam and an opioid together, they’ll prescribe the lowest dose of either drug needed to manage your symptoms.

To learn more, talk with your doctor or pharmacist.

Other warnings

Alprazolam could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether alprazolam oral tablet is a safe option for you.

Tell your doctor about your overall health and any past health conditions before you take alprazolam oral tablet. Health conditions and other factors you and your doctor should discuss include:

• breathing or lung problems, such as chronic obstructive pulmonary disease
• bipolar disorder, depression, or mania
• kidney problems, such as chronic kidney disease
• liver problems, such as cirrhosis

Allergic reaction

Alprazolam can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to alprazolam or any of its ingredients, your doctor will likely not prescribe alprazolam. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to alprazolam, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and alprazolam

Information about alprazolam and pregnancy and breastfeeding is described below.

Alprazolam and pregnancy

In general, alprazolam oral tablet should not be taken during pregnancy unless there are no other treatment options available. But if you and your doctor agree that the benefits outweigh the risks, your doctor may prescribe the drug during pregnancy.

Be sure to only take the drug during pregnancy if you and your doctor discuss the risks and benefits.

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 alprazolam.

Alprazolam and breastfeeding

Alprazolam oral tablet should not be taken while breastfeeding. 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 alprazolam.

What to ask your doctor

This article describes alprazolam oral tablet’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about alprazolam or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How do the side effects of alprazolam compare with other treatments for my condition?
• If I travel, will I have trouble getting my prescription through security or customs? Do I need to bring special documentation showing my need for the medication?
• Where does alprazolam fit in my treatment plan for my condition? Should I use it along with therapy or another treatment?
• If I have side effects from alprazolam, is there a lower dose you can prescribe?
• Will taking alprazolam affect my ability to complete my work or school responsibilities?

Article resources

• Alprazolam — alprazolam tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/f667458d-ddda-4e9e-e053-2995a90adb5a/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• George TT, et al. (2022). Alprazolam. https://www.ncbi.nlm.nih.gov/books/NBK538165/

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.