Alprazolam IR is a generic tablet prescribed to treat panic disorder with or without agoraphobia and short-term episodes of anxiety in adults. As with other drugs, alprazolam can cause side effects, such as sleepiness and skin inflammation.
Alprazolam immediate-release (IR) is available as the brand-name drug Xanax.
Alprazolam IR comes as an oral tablet. Alprazolam may also come in other forms, but this article does not cover them.
Read on to learn about potential common, mild, and serious side effects of alprazolam. For additional information about alprazolam IR, including details about its uses, see this alprazolam IR overview article.
Alprazolam has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Alprazolam: Side effect specifics” section.
Alprazolam can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took alprazolam in clinical trials:
- hypotension (low blood pressure)
- difficulty speaking clearly
- changes in sex drive
- difficulty with coordination or balance
Mild side effects can occur with alprazolam use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to alprazolam’s prescribing information.
Mild side effects that people using alprazolam have reported include:
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking alprazolam and want to tell the FDA about it, visit MedWatch.
Alprazolam may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to alprazolam’s prescribing information.
If you develop serious side effects while taking alprazolam, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects and their symptoms that people using alprazolam have reported include:
- hallucinations, which may include symptoms such as:
- seeing things that aren’t really there
- hearing sounds or voices that aren’t there
- mood changes in people with depression. This may include symptoms such as:
- worsening depression
- mania
- suicidal thoughts or behaviors
- mania, which may include symptoms such as:
- racing thoughts
- speaking extremely fast
- extremely high energy
- seizures, which may include symptoms such as:
- shaking or twitching
- jerky movement or muscle spasms
- risk of misuse and addiction*†
- risk of dependence and withdrawal*†
- risk of severe harm or death if taken with opioids*†
* For more information about this side effect, see “Side effect specifics.”
† Alprazolam has a
ALLERGIC REACTIONFor some people, alprazolam IR tablets can cause an allergic reaction.
However, it isn’t clear how often this side effect occurred in the drug’s studies.
In general, symptoms of allergic reaction can be mild or serious.
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 alprazolam IR tablet, your doctor may recommend taking a different medication instead.
Alprazolam may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.
Can alprazolam cause kidney problems?
It isn’t likely. Kidney problems weren’t a side effect reported in studies of alprazolam. However, you should tell your doctor if you have kidney problems. Kidney problems may affect how well the kidneys clear the medication from your body.
Talk with your doctor if you have additional questions about alprazolam and what to expect.
Are older adults more likely to experience side effects from alprazolam?
Yes, older adults are more likely to experience side effects from alprazolam. According to studies, older adults have higher alprazolam levels in their system after taking a dose compared to younger adults. If you are ages 65 or older, your doctor may start you on a lower alprazolam dosage.
Talk with your doctor if you have additional questions about alprazolam and what to expect.
Learn more about some of the side effects that alprazolam may cause. To find out how often side effects occurred in clinical trials, see alprazolam’s prescribing information.
Boxed warnings
Alprazolam has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). They alert providers and patients about drug effects that may be dangerous. Alprazolam boxed warnings include the following:
Risk of misuse and addiction
Misuse refers to taking a drug in a way other than how a doctor prescribes it. Examples of misuse include using the drug more often or at higher doses than recommended by your doctor. Misuse can lead to addiction. Addiction is when you continue taking a drug and can’t stop, even if it causes harm. Be aware that you can develop an addiction to alprazolam even if you take the medication as prescribed by your doctor.
Misuse and addiction may cause you to overdose on alprazolam, leading to serious effects. This can include difficulty breathing, seizures, and suicidal thoughts and behaviors. In rare cases, it can lead to coma and death. Taking alprazolam with alcohol, opioids, and certain other drugs can raise your risk of having these side effects.
Symptoms of misuse or addiction may include:
- taking alprazolam in higher doses or more often than prescribed
- inability to stop taking alprazolam even though it causes harm
- difficulty with personal and professional relationships
What you can do
Talk with your doctor about all your medical conditions, including any history of alcohol or drug misuse or addiction. They will help determine if alprazolam is the right drug for you.
Take alprazolam exactly as your doctor prescribes. Don’t share your medication with other people. Store alprazolam in a safe place away from children. Be aware that you can develop an addiction to alprazolam even if you take the medication as prescribed by your doctor. Talk with your doctor right away if you develop symptoms of misuse or addiction.
Risk of dependence and withdrawal
Taking alprazolam can lead to physical dependence. This condition occurs when your body relies on a drug to function as usual. Physical dependence isn’t the same as drug addiction. This explains the difference between addiction and dependence. If you have additional questions about the differences between these conditions, talk with your doctor.
If you suddenly stop taking alprazolam, you may experience withdrawal symptoms. These are side effects that can occur when you stop taking a drug that your body has become dependent on. Typically, people using alprazolam at higher dosages or for longer periods are more likely to experience these symptoms. Studies suggest that dosages greater than 4 milligrams (mg) daily and duration longer than 12 weeks may raise this risk.
Sometimes, these withdrawal symptoms can last several weeks to months and may cause serious and life threatening side effects. These may include seizures and suicidal thoughts. Other withdrawal symptoms may include:
- diarrhea and vomiting
- sweating
- watery eyes
- runny nose
- abdominal pain
- feeling more cold or hot than usual
- fever
- tremor (shaking)
What you can do
Don’t suddenly stop your alprazolam treatment. Talk with your doctor if you are interested in ending your alprazolam treatment. Your doctor may lower your dosage slowly over time before stopping alprazolam. This can help reduce your risk of withdrawal symptoms after you stop treatment.
If you have withdrawal symptoms after you’ve stopped taking alprazolam, talk with your doctor. They can recommend ways to ease these symptoms. If your symptoms feel life threatening, call 911 or your local emergency number right away.
Risk of severe harm or death if taken with opioids
Taking alprazolam with opioids can lead to an increased risk of death compared to use of opioids alone. This is because using both medications together can lead to excessive drowsiness, breathing problems, coma, and death. Due to this risk, doctors will typically not prescribe alprazolam with opioids. If there aren’t other options, they’ll limit your dosage and treatment duration to the minimum necessary to manage your symptoms.
What you can do
If you need to take alprazolam with opioids, your doctor will explain the risks to you before starting treatment. During treatment, they will also monitor you closely for symptoms of excessive drowsiness and difficulty breathing. These symptoms may require immediate emergency care. Until you are aware of how the combination of alprazolam and opioids affects your body, you should avoid driving or operating heavy machinery. This is due to the excessive drowsiness this medication combination can cause.
As a precaution, your doctor may also prescribe you naloxone (Narcan) nasal spray. It’s recommended to keep this drug near you. Narcan is typically used in an emergency situation to reverse the effects of opioids. Talk with your doctor if you have a question about what to expect with alprazolam treatment.
Sleepiness
Sleepiness was a common side effect reported in studies of alprazolam. Additionally, alprazolam can cause other effects on the central nervous system (brain). This may include slowing your thinking and motor skills. Taking alprazolam with alcohol, opioids, and certain other medications may further raise your risk for sleepiness. In fact, there is a boxed warning about the use of alprazolam with opioids. Please see the “Boxed warnings” section above to learn more.
What you can do
Talk with your doctor about all the medications you take, including prescriptions, over-the-counter medications, and supplements. Be sure also to discuss your alcohol consumption. They will help determine whether alprazolam is the right drug for you.
If starting alprazolam treatment, you should only take the medication as prescribed. Taking the medication at higher dosages or more often than your doctor prescribes can increase your risk of drowsiness. You also shouldn’t use alprazolam to manage conditions other than what your doctor has prescribed it for, such as difficulty sleeping.
Because alprazolam can slow your thinking and motor skills, you should avoid driving or operating machinery until you know how this drug affects your body.
Talk with your doctor to learn more about alprazolam and its expected side effects.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- 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’re not in the same household, stay on the phone with them until help arrives.
Below is important information you should consider before taking Alprazolam.
Alprazolam has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Alprazolam: Side effect specifics” section.
Other precautions
Before taking Alprazolam, discuss your health history with your doctor. Alprazolam may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- mental health conditions, such as depression
- liver or kidney problems
- breathing problems or lung disease
- history of alcohol or drug misuse or addiction
- age 65 years or older
- previous allergic reaction to alprazolam, any of its ingredients, or other benzodiazepine drugs
- pregnancy
- breastfeeding
- alcohol consumption
Disclaimer: Medical News Today 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.
