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All about: Xanax

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Generic Name: alprazolam (al PRAY zoe lam)
Brand Names: Niravam, Xanax, Xanax XR

What is alprazolam?

Alprazolam is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Alprazolam affects chemicals in the brain that may become unbalanced and cause anxiety.

Alprazolam is used to treat anxiety disorders, panic disorders, and anxiety caused by depression.

Alprazolam may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about alprazolam?

Do not use this medication if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax). This medication can cause birth defects in an unborn baby. Do not use alprazolam if you are pregnant.

Before taking alprazolam, tell your doctor if you have any breathing problems, glaucoma, kidney or liver disease, or a history of depression, suicidal thoughts, or addiction to drugs or alcohol.

Do not drink alcohol while taking alprazolam. This medication can increase the effects of alcohol.

Avoid using other medicines that make you sleepy. They can add to sleepiness caused by alprazolam.

Alprazolam may be habit-forming and should be used only by the person it was prescribed for. Alprazolam should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

It is dangerous to try and purchase alprazolam on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of alprazolam purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.

What should I discuss with my healthcare provider before taking alprazolam?

It is dangerous to try and purchase alprazolam on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of alprazolam purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.

Do not use this medication if you have:
  • narrow-angle glaucoma;

  • if you are also taking itraconazole (Sporanox) or ketoconazole (Nizoral); or

  • if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).

Before taking alprazolam, tell your doctor if you are allergic to any drugs, or if you have:

  • asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;

  • glaucoma;

  • kidney or liver disease (especially alcoholic liver disease);

  • a history of depression or suicidal thoughts or behavior; or

  • a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use alprazolam, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category D. Alprazolam can cause birth defects in an unborn baby. Do not use alprazolam without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Alprazolam can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. The sedative effects of alprazolam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking alprazolam. Do not give this medication to anyone under 18 years old.

How should I take alprazolam?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Alprazolam may be habit-forming and should be used only by the person it was prescribed for. Alprazolam should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Measure the liquid form of alprazolam with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

To take alprazolam orally disintegrating tablets (Niravam):

  • Using dry hands, remove a tablet from the bottle and place the tablet on your tongue. It will begin to dissolve right away.

  • Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

  • Swallow several times as the tablet dissolves. If desired, you may drink liquid after the tablet has completely dissolved.

Contact your doctor if this medicine seems to stop working as well in treating your panic or anxiety symptoms.

Your symptoms may return when you stop using alprazolam after using it over a long period of time. You may also have seizures or withdrawal symptoms when you stop using alprazolam. Withdrawal symptoms may include blurred vision, trouble concentrating, loss of appetite, diarrhea, muscle twitching, numbness or tingling, or increased sensations.

Do not stop using alprazolam suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

To be sure this medication is helping your condition, your doctor will need to check your progress on a regular basis. Do not miss any scheduled visits to your doctor.

Store alprazolam at room temperature away from moisture, heat, and light. Remove any cotton from the bottle of disintegrating tablets, and keep the bottle tightly closed.

Keep track of how many pills have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of alprazolam can be fatal.

Symptoms of an alprazolam overdose may include extreme drowsiness, confusion, muscle weakness, loss of balance or coordination, feeling light-headed, fainting, or coma.

What should I avoid while taking alprazolam?

Do not drink alcohol while taking alprazolam. This medication can increase the effects of alcohol. Alprazolam can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can increase some of the side effects of alprazolam.

Grapefruit and grapefruit juice may interact with alprazolam and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Alprazolam side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • unusual risk-taking behavior, decreased inhibitions, no fear of danger;

  • depressed mood, thoughts of suicide or hurting yourself;

  • hyperactivity, agitation, hostility, hallucinations;

  • feeling light-headed, fainting;

  • seizure (convulsions);

  • urinating less than usual or not at all;

  • muscle twitching, tremor; or

  • jaundice (yellowing of the skin or eyes).

Less serious side effects are more likely to occur, such as:

  • drowsiness, dizziness, feeling irritable;

  • amnesia or forgetfulness, trouble concentrating;

  • sleep problems (insomnia);

  • muscle weakness, lack of balance or coordination, slurred speech;

  • blurred vision;

  • nausea, vomiting, constipation, appetite or weight changes;

  • dry or watery mouth, increased sweating; or

  • loss of interest in sex.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect alprazolam?

Before taking alprazolam, tell your doctor if you are using any of the following drugs:

  • birth control pills;

  • cimetidine (Tagamet);

  • diltiazem (Tiazac, Cartia, Cardizem);

  • isoniazid (Nydrazid, Rifamate);

  • propoxyphene (Darvon, Darvocet);

  • seizure medication;

  • antibiotics such as fluconazole (Diflucan), itraconazole (Sporanox) or ketoconazole (Nizoral); or

  • antidepressants such as fluvoxamine (Luvox), desipramine (Norpramin), or imipramine (Janimine, Tofranil).

If you are using any of these drugs, you may not be able to use alprazolam, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect alprazolam. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has information about alprazolam written for health professionals that you may read.

What does my medication look like?

Alprazolam is available with a prescription under the brand names Xanax and Niravam. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 6.02. Revision Date: 2/23/07 11:20:38 AM.

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