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Side Effects
Serious

Difficulty concentrating, outbursts of anger, other behavior problems, depression, hallucinations, low blood pressure (causing faintness or confusion), memory impairment, muscle weakness, skin rash or itching, sore throat, fever and chills, sores or ulcers in throat or mouth, unusual bruising or bleeding, extreme fatigue, yellowish tinge to eyes or skin. Call your doctor immediately.
Common

Drowsiness, loss of coordination, unsteady gait, dizziness, lightheadedness, slurred speech.
Less Common

Change in sexual desire or ability, constipation, false sense of well-being, nausea and vomiting, urinary problems, unusual fatigue.
Alprazolam


Drug Class:
Benzodiazepine tranquilizer; antianxiety agent

Available OTC?: No

Available Generic?: Yes

Generic 0.25 mg
(Geneva)
Available In
Why Prescribed
How It Works
Range and Frequency
Onset of Effect
Duration of Action
Dietary Advice
Storage
Missed Dose
Stopping the Drug
Prolonged Use
Over 60
Driving and Hazardous Work
Alcohol
Pregnancy
Breast Feeding
Infants and Children
Special Concerns
Overdose Symptoms
What to Do
Drug Interactions
Food Interactions
Disease Interactions


Available In
Tablets, oral solution

Why Prescribed
To treat anxiety and panic disorder.

How It Works
In general, alprazolam produces mild sedation by depressing activity in the central nervous system. In particular, alprazolam appears to enhance the effect of gamma-aminobutyric acid (GABA), a natural chemical that inhibits the firing of neurons and dampens the transmission of nerve signals, thus decreasing nervous excitation.

Range and Frequency
Adults: Initial dose is 1.5 mg a day, taken in three divided doses; may be gradually increased to a maximum dose of 4 mg a day. Older adults: Initial dose is 0.5 to 0.75 mg per day, taken in two or three divided doses; may be gradually increased to a maximum dose of 2 mg a day. Children: Not usually prescribed.

Onset of Effect
Two hours.

Duration of Action
Up to six hours.

Dietary Advice
Alprazolam can be taken on an empty stomach or with food or milk.

Storage
Store in a tightly sealed container away from heat and direct light.

Missed Dose
If you miss a dose, take it if you remember within one hour. Otherwise, skip the missed dose and take the next one at the regular time. Do not double the next dose.

Stopping the Drug
Never stop taking the drug abruptly, as this can cause withdrawal symptoms (seizures, sleep disruption, nervousness, irritability, diarrhea, abdominal cramps, muscle aches, memory impairment). Dosage should be reduced gradually as directed by your doctor.

Prolonged Use
Short-term therapy (eight weeks or less) is typical; do not take it for a longer period unless so advised by your doctor.

Over 60
Use with caution; side effects such as drowsiness and dizziness may be more pronounced in older patients.

Driving and Hazardous Work
Alprazolam can impair mental alertness and physical coordination. Adjust your activities accordingly.

Alcohol
Alcohol intake should be extremely moderate or stopped altogether while taking alprazolam.

Pregnancy
Use of this drug during pregnancy should be avoided if possible. Be sure to tell your doctor if you are pregnant or plan to become pregnant.

Breast Feeding
Alprazolam passes into breast milk; do not take it while nursing.

Infants and Children
Safety and effectiveness have not been established for children under age 18.

Special Concerns
Use of this drug can lead to psychological or physical dependence. Short-term therapy (eight weeks or less) is typical; patients should not take the drug for a longer period unless so advised by their doctor. Never take more than the prescribed daily dose.

Overdose Symptoms
Extreme drowsiness, confusion, slurred speech, slow reflexes, poor coordination, staggering gait, tremor, slowed breathing, loss of consciousness.

What to Do
Call your doctor, emergency medical services (EMS), or the nearest poison control center immediately.

Drug Interactions
Other drugs may interact with alprazolam. Consult your doctor for specific advice if you are taking any drugs that depress the central nervous system; these include antihistamines, antidepressants (including nefazodone) or other psychiatric medications, barbiturates, sedatives, cough medicines, decongestants, and painkillers. Be sure your doctor knows about any over-the-counter medication you may take.

Food Interactions
None reported.

Disease Interactions
Consult your doctor if you have a history of alcohol or drug abuse, stroke or other brain disease, any chronic lung disease, hyperactivity, depression or other mental illness, myasthenia gravis, sleep apnea, epilepsy, porphyria, kidney disease, or liver disease.

Date Published: 04/13/2005
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