Alprazolam belongs to the class of medicines called benzodiazepines. It is used for the short-term symptomatic relief of excessive anxiety. It is also used to treat generalized anxiety disorder and panic disorder. Alprazolam works by slowing down the brain (central nervous system).
Nat-Alpraz is no longer being manufactured for sale in Canada. For brands that may still be available, search under alprazolam. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.
The recommended dose of alprazolam for adults varies depending on its use. The starting dose for excessive anxiety is 0.25 mg taken 2 or 3 times a day. This is gradually increased until anxiety is controlled and side effects are minimized. Elderly patients may be started at a lower dose of 0.125 mg taken 2 or 3 times a day. The usual maximum dose is 3 mg daily.
The starting dose for panic attacks is 0.5 mg to 1 mg at bedtime or 0.5 mg taken 3 times daily. The dose is then gradually increased until there are no more panic attacks.
The dose is usually started low and increased if necessary, as prescribed by your doctor. It is important that the dose be individualized to your specific needs to avoid excessive sedation or motor impairment.
Alprazolam may be habit-forming when taken for long periods of time. If you have been taking this medication regularly for a long period of time (i.e., more than one month), do not stop taking the medication without speaking with your doctor. A gradual reduction in dose is recommended when stopping this medication to avoid withdrawal symptoms.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store at room temperature in a dry place and keep it out of reach of children.
Do not take this medication if you:
Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Alcohol and other medications that cause drowsiness: People taking this medication should not combine it with alcohol and avoid combining it with other medications, such as narcotic pain relievers, that cause drowsiness. Doing so can cause additive drowsiness and reduced breathing as well as other side effects, which can be dangerous and possibly fatal.
Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as alprazolam. Severe withdrawal symptoms may be experienced if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually, under medical supervision, can help prevent or decrease these withdrawal symptoms.
Because the treatment of panic disorder often requires the use of average daily doses of alprazolam above 3 mg, the risk of dependence among people with panic disorder may be higher than that among those treated for less severe anxiety.
Drowsiness/reduced alertness: Alprazolam may affect the mental or physical abilities needed to drive or operate machinery. Do not engage in activities requiring mental alertness, judgment, and physical coordination until you have established how alprazolam affects you. Alcohol can increase the drowsiness effects of alprazolam and should be avoided.
Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Mood changes: Anxiety disorders are often associated with mood changes, such as depression, mania, or ideas of suicide or self-harm. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.
Pregnancy: Other benzodiazepine medications similar to alprazolam are known to increase the risk of birth defects when taken by a woman who is pregnant. The safety of alprazolam during pregnancy has not been established. It is not recommended for use by pregnant women.
Breast-feeding: Alprazolam may pass into breast milk. If you are a breast-feeding mother and are taking alprazolam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children and adolescents: The safety and efficacy of alprazolam for children and adolescents under 18 years of age have not been established.
Seniors: Seniors may be at increased risk of experiencing side effects such as sedation, reduced coordination, and dizziness. Use extra caution when rising from a sitting or lying position to reduce the risk of severe dizziness and falls.
There may be an interaction between alprazolam and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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