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Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Apo-Alpraz (CA), Niravam, Novo-Alprazol (CA), Nu-Alpraz (CA), Xanax, Xanax TS (CA), Xanax XR

😞😴😙 Pharmacologic class: Benzodiazepine

😞😴😙 Therapeutic class: Anxiolytic

😞😴😙 Controlled substance schedule IV

😞😴😙 Pregnancy risk category D


😞😴😙 Unclear. Thought to act at limbic, thalamic, and hypothalamic levels of CNS to produce sedative, anxiolytic, skeletal muscle relaxant, and anticonvulsant effects.


😞😴😙 Solution: 1 mg/ml

😞😴😙 Tablets (extended-release): 0.5 mg, 1 mg, 2 mg, 3 mg

😞😴😙 Tablets (immediate-release): 0.25 mg, 0.5 mg, 1 mg, 2 mg

😞😴😙 Tablets (orally disintegrating): 0.25 mg, 0.5 mg, 1 mg, 2 mg

Indications and dosages

😞😴😙 Anxiety disorders

😞😴😙 Adults: Initially, 0.25 to 0.5 mg P.O. t.i.d. Maximum dosage is 4 mg daily in divided doses.

😞😴😙 Elderly patients: Initially, 0.25 mg P.O. two or three times daily. Maximum dosage is 4 mg daily in divided doses.

😞😴😙 Panic disorders

😞😴😙 Adults:Immediate-release or orally disintegrating tablets-Initially, 0.5 mg P.O. t.i.d. Extended-release tablets-Initially, 0.5 to 1 mg P.O. daily. Usual dosage is 3 to 6 mg daily, with a maximum dosage of 10 mg daily. For all dosage forms, increase by a maximum of 1 mg daily at intervals of 3 to 4 days, with a maximum of 10 mg daily in divided doses.

Dosage adjustment

😞😴😙 • Hepatic impairment

Off-label uses

😞😴😙 • Agoraphobia

😞😴😙 • Depression

😞😴😙 • Premenstrual syndrome


😞😴😙 • Hypersensitivity to benzodiazepines

😞😴😙 • Narrow-angle glaucoma

😞😴😙 • Labor and delivery

😞😴😙 • Pregnancy or breastfeeding


😞😴😙 Use cautiously in:

😞😴😙 • hepatic dysfunction

😞😴😙 • history of attempted suicide or drug dependence

😞😴😙 • elderly patients.


😞😴😙 • Don't give with grapefruit juice.

😞😴😙 • Make sure patient swallows extended-release tablets whole without chewing or crushing.

😞😴😙 • Mix oral solution with liquids or semisolid foods and instruct patient to consume entire amount immediately.

😞😴😙 • Administer orally disintegrating tablets by placing tablet on patient's tongue. If only one-half of scored tablet is used, discard unused portion immediately.

😞😴😙 Don't withdraw drug suddenly. Seizures and other withdrawal symptoms may occur unless dosage is tapered carefully.

Adverse reactions

😞😴😙 CNS: dizziness, drowsiness, depression, fatigue, light-headedness, disorientation, anger, hostility, euphoria, hypomanic episodes, restlessness, confusion, crying, delirium, headache, stupor, rigidity, tremor, paresthesia, vivid dreams, extrapyramidal symptoms

😞😴😙 CV: bradycardia, tachycardia, hypertension, hypotension, palpitations, CV collapse

😞😴😙 EENT: blurred or double vision, nystagmus, nasal congestion

😞😴😙 GI: gastric disorders, dysphagia, anorexia, increased salivation, dry mouth

😞😴😙 GU: menstrual irregularities, urinary retention, urinary incontinence, libido changes, gynecomastia

😞😴😙 Hematologic: blood dyscrasias such as eosinophilia, agranulocytosis, leukopenia, and thrombocytopenia

😞😴😙 Hepatic: hepatic dysfunction (including hepatitis)

😞😴😙 Musculoskeletal: muscle rigidity, joint pain

😞😴😙 Skin: dermatitis, rash, pruritus, urticaria, increased sweating

😞😴😙 Other: weight loss or gain, hiccups, fever, edema, psychological drug dependence, drug tolerance


😞😴😙 Drug-drug.Antidepressants, antihistamines, opioids, other benzodiazepines: increased CNS depression

😞😴😙 Barbiturates, rifampin: increased metabolism and decreased efficacy of alprazolam

😞😴😙 Cimetidine, disulfiram, erythromycin, fluoxetine, hormonal contraceptives, isoniazid, ketoconazole, metoprolol, propoxyphene, propranolol, valproic acid: decreased metabolism and increased action of alprazolam

😞😴😙 Digoxin: increased risk of digoxin toxicity

😞😴😙 Levodopa: decreased antiparkinsonian effect

😞😴😙 Theophylline: increased sedative effect

😞😴😙 Tricyclic antidepressants (TCAs): increased TCA blood levels

😞😴😙 Drug-diagnostic tests.Itraconazole, ketoconazole: increased alprazolam plasma level

😞😴😙 Drug-food.Grapefruit juice: decreased drug metabolism and increased blood level

😞😴😙 Drug-herbs.Chamomile, hops, kava, skullcap, valerian: increased CNS depression

😞😴😙 Drug-behaviors.Alcohol use: increased CNS depression

😞😴😙 Smoking: decreased alprazolam efficacy

Patient monitoring

😞😴😙 • Watch for excessive CNS depression if patient is concurrently taking antidepressants, other benzodiazepines, antihistamines, or opioids.

😞😴😙 • If patient is taking TCAs concurrently, watch for increase in adverse TCA effects.

😞😴😙 • Monitor CBC and liver and kidney function test results.

😞😴😙 • Monitor vital signs and weight.

😞😴😙 • Report signs of drug abuse, including frequent requests for early refills.

Patient teaching

😞😴😙 • Instruct patient to swallow extended- release tablets whole without crushing or chewing.

😞😴😙 Tell patient that drug may make him more depressed, angry, or hostile. Urge him to contact prescriber immediately if he thinks he's dangerous to himself or others.

😞😴😙 • Inform patient that drug may cause tremors, muscle rigidity, and other movement problems. Advise him to report these effects to prescriber.

😞😴😙 Caution patient not to stop taking drug suddenly. Withdrawal symptoms, including seizures, may occur unless drug is tapered carefully.

😞😴😙 • Advise patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

😞😴😙 • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


A benzodiazepine drug, C17H13ClN4, used to treat panic disorder and other anxiety disorders.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


Neuropharmacology A benzodiazepine used to manage cholecystokinin related anxiety-panic disorders and CNS depression Adverse effects Drowsiness, loss of coordination, mood swings Toxic range > 75 µg/L
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


A benzodiazepine anti-anxiety drug. A brand name is Xanax.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


A benzodiazepine used to manage anxiety disorders and panic attack; tolerance, habituation, or dependency may result from increased dosage.
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive?
The estimated national prevalence of lifetime non-medical use of alprazolam was 0.32%, and 1.30% for diazepam (valium), another anti-anxiety medication.
Addiction expert Dr Roy Robertson, who was Scott's GP, said: "Alprazolam has been a phenomenon in the east of Scotland for the past two years and has caused a lot of problems."
The APA Practice Guideline also states that although the highest "usual therapeutic dose" for panic disorder is clonazepam 2 mg/d or alprazolam 4 mg/d, "higher doses are sometimes used for patients who do not respond to the usual therapeutic dose." (1)
Biz calismamizda acik kalp cerrahisinde premedikasyon amacli uygulanan alprazolam ile melatoninin sistemik oksidatif stres, glikokaliks butunlugu ve postoperatif noro-kognitif fonksiyonlar uzerine etkilerini karsilastirmayi amacladik.
The patients given preoperative alprazolam had 52% rate of success.
"The board has received a number of reports of increasing use of the drug alprazolam [brand Xanax] even though it is rarely prescribed by GPs here.
However, the price of alprazolam in the JAS is the among the lowest as compared to market prices (Table 3).
Stevens receives 3 mg extended release alprazolam (Xanax[R]) daily.
A middle-aged male had success rapidly reducing fast-acting alprazolam (Xanax) dosage by taking very high doses of niacin, along with gamma-aminobutyric acid (GABA) and vitamin C.
During her next appointment with her physician, he prescribed alprazolam and morphine sulfate daily.
The intercepted drugs consist of 100,000 200mg tablets of Cytotec, 31,014 10mg tablets of Valium, 2,700 10mg tablets of Xolnox, 24,000 10mg tablets of Ritalin, 27,492 tablets of Alprazolam and 7,000 10 mg tablets of Ambin.