Alprazolam (patient information)

Why this medication is prescribed
Alprazolam is used to treat anxiety disorders and panic attacks. Alprazolam is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain.

How this medication should be used
Alprazolam comes as a tablet and a concentrated solution (liquid) to take by mouth. It usually is taken two to four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take alprazolam exactly as directed.

To take the concentrated liquid, use only the dropper that came with your prescription. Draw into the dropper the amount prescribed for one dose. Squeeze the dropper contents into a liquid or semi-solid food such as water, juice, soda, applesauce, or pudding. Stir the liquid or food gently for a few seconds. The concentrated liquid will blend completely with the food. Drink or eat the entire mixture immediately. Do not store for future use.

Your doctor will probably start you on a low dose of alprazolam and gradually increase your dose, not more than once every 3 or 4 days.

Alprazolam can be habit-forming. Do not take a larger dose or take it more often or for a longer time than your doctor tells you to. Do not stop taking alprazolam without talking to your doctor. Suddenly stopping to take alprazolam may worsen your condition and cause withdrawal symptoms (anxiousness, sleeplessness, irritability, and seizures). Withdrawal symptoms may be worse if you take more than 4 mg of alprazolam every day. Your doctor will decrease your dose gradually.

Other uses for this medicine
Alprazolam also is used sometimes to treat depression, fear of open spaces (agoraphobia), and premenstrual syndrome. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special Precautions
Before taking alprazolam:


 * tell your doctor and pharmacist if you are allergic to alprazolam, chlordiazepoxide (Librium, Librax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), estazolam (ProSom), flurazepam (Dalmane), halazepam (Paxipam), lorazepam (Ativan), oxazepam (Serax), prazepam (Centrax), quazepam (Doral), temazepam (Restoril), triazolam (Halcion), or any other medications.
 * do not take alprazolam if you are taking itraconazole (Sporanox) or ketoconazole (Nizoral).
 * tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); antidepressants ('mood elevators') such as desipramine (Norpramin), imipramine (Tofranil), and nefazodone (Serzone); antifungals such as fluconazole (Diflucan); antihistamines; cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); diltiazem (Cardizem, Dilacor, Tiazac); ergotamine (Cafatine, Cafergot, Wigraine, others); erythromycin (E.E.S., E-Mycin, Erythrocin); isoniazid (INH, Nydrazid); medications for mental illness and seizures; nicardipine (Cardene); nifedipine (Adalat, Procardia); oral contraceptives (birth control pills); propoxyphene (Darvon); selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
 * tell your doctor if you have or have ever had glaucoma; depression; or lung, kidney, or liver disease.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking alprazolam, call your doctor immediately.
 * if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking alprazolam.
 * you should know that alprazolam may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
 * remember that alcohol can add to the drowsiness caused by this medication.

Special dietary instructions
Talk to your doctor about drinking grapefruit juice while taking this medicine.

What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Minor Side Effects
Alprazolam may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:


 * drowsiness
 * light-headedness
 * tiredness
 * dizziness
 * irritability
 * talkativeness
 * dry mouth
 * increased salivation
 * changes in sex drive or ability
 * changes in appetite
 * weight changes
 * difficulty urinating

Severe Side Effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:


 * seizures
 * seeing things or hearing voices that do not exist (hallucinating)
 * severe skin rash
 * yellowing of the skin or eyes
 * memory problems
 * confusion
 * problems with coordination

Alprazolam may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:


 * drowsiness
 * confusion
 * problems with coordination
 * coma

Other information
Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Alprazolam Intensol®
 * Xanax®