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Xanax (Alprazolam)
Patient Information
Pronounced: ZAN-ax
Generic name: Alprazolam Other brand name: Xanax XR
Why is Xanax prescribed?
Xanax is a tranquilizer used in the short-term relief of symptoms of
anxiety or the treatment of anxiety disorders. Anxiety disorder is marked by
unrealistic worry or excessive fears and concerns. Anxiety associated with
depression is also responsive to Xanax.
Xanax and the extended-release formulation, Xanax XR, are also used in
the treatment of panic disorder, which appears as unexpected panic attacks
and may be accompanied by a fear of open or public places called
agoraphobia. Only your doctor can diagnose panic disorder and best advise
you about treatment.
Some doctors prescribe Xanax to treat alcohol withdrawal, fear of open
spaces and strangers, depression, irritable bowel syndrome, and premenstrual
syndrome.
Most important fact about Xanax
Tolerance and dependence can occur with the use of Xanax. You may
experience withdrawal symptoms if you stop using Xanax abruptly. The drug
dosage should be gradually reduced and only your doctor should advise you on
how to discontinue or change your dose.
How should you take Xanax?
Xanax may be taken with or without food. Take it exactly as prescribed.
Do not chew, crush, or break the Xanax XR tablets.
--If you miss a dose...
If you are less than 1 hour late, take it as soon as you remember.
Otherwise skip the dose and go back to your regular schedule. Never take 2
doses at the same time.
--Storage instructions...
Store Xanax at room temperature.
What side effects may occur when using Xanax?
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor can
determine if it is safe for you to continue taking Xanax. Your doctor should
periodically reassess the need for this drug.
Side effects of Xanax are usually seen at the beginning of treatment and
disappear with continued medication. However, if dosage is increased, side
effects will be more likely.
-
More common side effects may include:
Abdominal discomfort, abnormal involuntary movement, agitation,
allergies, anxiety, blurred vision, chest pain, confusion, constipation,
decreased or increased sex drive, depression, diarrhea, difficult
urination, dream abnormalities, drowsiness, dry mouth, fainting,
fatigue, fluid retention, headache, hyperventilation (too frequent or
too deep breathing), inability to fall asleep, increase or decrease in
appetite, increased or decreased salivation, impaired memory,
irritability, lack of or decreased coordination, light-headedness, low
blood pressure, menstrual problems, muscular twitching, nausea and
vomiting, nervousness, painful menstruation, palpitations, rapid
heartbeat, rash, restlessness, ringing in the ears, sedation, sexual
dysfunction, skin inflammation, speech difficulties, stiffness, stuffy
nose, sweating, tiredness/sleepiness, tremors, upper respiratory
infections, weakness, weight gain or loss
-
Less common or rare side effects may
include: Abnormal muscle tone, arm or leg pain, concentration
difficulties, dizziness, double vision, fear, hallucinations, hot
flushes, inability to control urination or bowel movements, infection,
itching, joint pain, loss of appetite, muscle cramps, muscle spasticity,
rage, seizures, shortness of breath, sleep disturbances, slurred speech,
stimulation, talkativeness, taste alterations, temporary memory loss,
tingling or pins and needles, uninhibited behavior, urine retention,
weakness in muscle and bone, yellow eyes and skin
-
Side effects due to decrease or
withdrawal from Xanax or Xanax XR: Anxiety, blurred vision,
decreased concentration, decreased mental clarity, depression, diarrhea,
headache, heightened awareness of noise or bright lights, hot flushes,
impaired sense of smell, insomnia, loss of appetite, loss of reality,
muscle cramps, nervousness, rapid breathing, seizures, tingling
sensation, tremor, twitching, weight loss
Why should this drug not be prescribed?
If you are sensitive to or have ever had an allergic reaction to Xanax or
other tranquilizers, you should not take this medication. Also avoid Xanax
while taking the antifungal drugs Sporanox or Nizoral. Make sure that your
doctor is aware of any drug reactions that you have experienced.
Do not take this medication if you have been diagnosed with the eye
condition called narrow-angle glaucoma.
Anxiety or tension related to everyday stress usually does not require
treatment with Xanax. Discuss your symptoms thoroughly with your doctor.
Special warnings about Xanax
Xanax may cause you to become drowsy or less alert; therefore, driving or
operating dangerous machinery or participating in any hazardous activity
that requires full mental alertness is not recommended.
If you are being treated for panic disorder, you may need to take a
higher dose of Xanax than for anxiety alone. High doses--more than 4
milligrams a day--of this medication taken for long intervals may cause
emotional and physical dependence. It is important that your doctor
supervise you carefully when you are using this medication.
Remember that withdrawal symptoms can occur when Xanax is stopped
suddenly or the doctor lowers your dosage. These include abnormal skin
sensations, blurred vision, decreased appetite, diarrhea, distorted sense of
smell, heightened senses, muscle cramps or twitching, problems
concentrating, weight loss, and rarely, seizures. Withdrawal symptoms can be
minimized or even avoided altogether by decreasing the Xanax dose gradually.
As with all antianxiety medication, there is a small chance that Xanax
could encourage suicidal thoughts or episodes of euphoria known as mania. If
you notice any new or unusual symptoms after starting Xanax, call your
doctor immediately.
Xanax should be used with caution in elderly or weak patients, and in
those with lung disease, alcoholic liver disease, or any disorder that could
hinder the elimination of the drug.
Possible food and drug interactions when taking Xanax
Xanax may intensify the effect of alcohol. Do not drink alcohol while
taking this medication.
Never combine Xanax with Sporanox or Nizoral. These drugs cause a buildup
of Xanax in the body.
If Xanax is taken with certain other drugs, the effects of either could
be increased, decreased, or altered. It is important to check with your
doctor before combining Xanax with the following:
Amiodarone (Cordarone)
Antihistamines such as Benadryl and Tavist
Carbamazepine (Tegretol)
Certain antibiotics such as Biaxin and erythromycin
Certain antidepressant drugs, including Elavil, Norpramin, and Tofranil
Cimetidine (Tagamet)
Cyclosporine (Neoral, Sandimmune)
Digoxin (Lanoxin)
Diltiazem (Cardizem)
Disulfiram (Antabuse)
Ergotamine
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Grapefruit juice
Isoniazid (Rifamate)
Major tranquilizers such as Mellaril and Thorazine
Nefazodone (Serzone)
Nicardipine (Cardene)
Nifedipine (Adalat, Procardia)
Oral contraceptives
Other central nervous system depressants such as Valium and Demerol
Paroxetine (Paxil)
Propoxyphene (Darvon)
Sertraline (Zoloft)
Special information if you are pregnant or breastfeeding
Do not take this medication if you are pregnant or planning to become
pregnant. There is an increased risk of respiratory problems and muscular
weakness in your baby. Infants may also experience withdrawal symptoms.
Xanax may appear in breast milk and could affect a nursing infant. If this
medication is essential to your health, your doctor may advise you to stop
breastfeeding until your treatment with this medication is finished.
Recommended dosage for Xanax
ADULTS
Anxiety disorder
The usual starting dose of Xanax is 0.25 to 0.5 milligram taken 3 times a
day. The dose may be increased every 3 to 4 days to a maximum daily dose of
4 milligrams, divided into smaller doses.
Panic disorder
The usual starting dose of regular Xanax is 0.5 milligram 3 times a day.
This dose can be increased by 1 milligram a day every 3 or 4 days. You may
be given a dose from 1 up to a total of 10 milligrams, according to your
needs. The typical dose is 5 to 6 milligrams a day.
If you're taking Xanax XR, the usual starting dose is 0.5 to 1 milligram
once a day taken in the morning. Depending on your response, the dose may be
gradually increased by no more than 1 milligram every 3 or 4 days. The usual
effective dose is 3 to 6 milligrams a day. Some people may need a larger
dose to relieve their symptoms. Others, including older adults and those
with liver disease or other serious illnesses, may need to use lower doses.
Your doctor will reassess your treatment periodically to be sure you're
getting the right amount of medication.
CHILDREN
Safety
and effectiveness have not been established in children under 18 years of
age.
OLDER ADULTS
The usual starting dose for an anxiety disorder is 0.25 milligram, 2 or 3
times daily. The starting dose of Xanax XR is 0.5 milligrams once a day.
This dose may be gradually increased if needed and tolerated.
PATIENTS SWITCHING FROM XANAX TO XANAX XR
If you're taking divided doses of Xanax, the doctor will switch you to a
once-daily dose of Xanax XR that equals the current amount you're taking. If
your symptoms return after switching, the dose can be increased as needed.
Overdosage
Any medication taken in excess can have serious consequences. If you
suspect an overdose, seek medical attention immediately.
- Symptoms of Xanax overdose may include: Confusion, coma, impaired
coordination, sleepiness, slowed reaction time An overdose of Xanax,
alone or after combining it with alcohol, can be fatal.
Full Xanax Prescription Information
Xanax Medication Guide
Last updated 12/2005
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