- Alprazolam makes you calmer, less anxious and relaxes your muscles.
- With feelings of anxiety, anxiety, panic disorder or social phobia .
- You will become calmer within a few hours. The tablets work for 8 to 12 hours. A delayed-release tablet can work for up to 24 hours.
- Do not use alprazolam for more than a few weeks in a row if you have anxiety. With panic disorder or social phobia , you often have to use it for six months or 1 year.
- Are you taking alprazolam every day? Then it may be difficult to stop. Have you used it for more than a few weeks in a row? Do not stop without first talking to your doctor or pharmacist.
- You may become drowsy, sleepy or tired. You also react less quickly, which makes it easier for you to fall. That can take until the next day.
- Are you taking alprazolam every day? Then you are not allowed to drive.
- Do you take alprazolam occasionally? Then you are not allowed to drive for 3 days after taking alprazolam.
- Are you taking more than 1 milligram per day? Then talk to your doctor.
- Be careful with drinking alcohol. This can make you even drowsy.
- Are you pregnant or do you want to become pregnant? Ask your doctor if you can take this medicine. This drug can be bad for the baby.
- Do you want to breastfeed? Then talk to your doctor or pharmacist. This drug passes into breast milk. It can then cause side effects in the child.
Anxiety and anxiety
- Everyone is sometimes anxious. Fear is a normal reaction to imminent danger. It leads to caution or flight, so it is a useful form of self-protection.
- Sometimes someone is anxious when there is little reason to do so, for example if you do not dare to go outside or do not dare to go shopping in a busy store. We then speak of an anxiety disorder.
- Anxiety often causes complaints such as headache, stomach pain, sleeping problems and irritability. Intense anxiety can cause: palpitations, tightness, sweating, chest pain, tremors, a feeling of fainting or tingling in the limbs.
- In case of anxiety and tension due to severe events, you can use this medication for a few days to weeks. Do the anxiety and tension last longer or is there a psychological cause? Then they are usually treated with psychotherapy or with antidepressants.
- Alprazolam dampens emotions and therefore has a calming effect when you are anxious or tense. This also reduces physical complaints, such as palpitations, abdominal pain, tremors and sweating, which are often accompanied by anxiety and tension.
- This medication is a temporary relief for these symptoms. However, it does not solve the cause of your tension. It can be useful for very intense emotions and for a short period of time.
- You will become calmer within a few hours after taking it. This effect lasts for eight to twelve hours. A delayed-release tablet works for 12 to 24 hours.
- After a few weeks, there is a chance that you have become dependent on the drug.
- You will notice this from withdrawal symptoms when you stop swallowing, such as anxiety, headaches, muscle pain, insomnia, restlessness and irritability. Therefore do not use this medicine for longer than a few weeks.
- Panic attacks also cause physical symptoms, such as sweating, tremors, dizziness, nausea, weak legs, chest pain and palpitations. The attacks can give the feeling of dying or going mad.
- In a panic disorder, people have unusually strong panic attacks. The attacks rule their lives. Just the thought of a panic attack can lead to panic. People try to avoid situations in which a panic attack occurs. Sometimes it is no longer possible to go out to work or go outside (fear of the street) for fear of a new attack.
- If the complaints occur extremely often and are very severe, they can greatly reduce your well-being and that of the people in your environment.
- The treatment of panic disorder consists of behavioral therapy, often combined with an antidepressant, such as fluvoxamine, paroxetine, clomipramine or imipramine.
- Alprazolam is sometimes given at the beginning of treatment with one of these antidepressants. It takes a few weeks before these have sufficient effect. In the meantime, alprazolam will reduce the number of panic attacks. Occasionally the antidepressants do not work sufficiently after a few weeks. Then the doctor sometimes prescribes alprazolam instead.
- Alprazolam has a calming effect and reduces anxiety. This makes you less likely to panic. It works within hours of taking it. This effect lasts for eight to twelve hours. A delayed-release tablet works for 12 to 24 hours.
- In a social phobia people have an extreme and unhealthy fear of criticism from others. One suffers from physical symptoms, such as tremors, sweating, flushing and palpitations. Everyone suffers from this to a minor extent.
- If the complaints occur extremely often, your doctor may opt for continuous treatment with a drug from the antidepressant group, in addition to discussions with a psychiatrist or psychologist (behavioral therapy). If this has insufficient effect, the doctor can prescribe alprazolam.
- Alprazolam has a calming effect and reduces anxiety. This makes you react less violently to situations that are socially threatening to you.
- You will become calmer within a few hours of taking it. This effect lasts for 8 to 12 hours. A delayed-release tablet works for 12-24 hours.
In addition to the desired effect, this drug can cause side effects.
The main side effects are the following.
Regularly (affects more than 30 in 100 people) , especially during the first weeks of use
- Drowsiness, fatigue and, less often, sleepiness . This reduces your ability to react and concentrate, which increases the risk of accidents. Accidents can occur, for example, in traffic, when climbing a ladder, operating equipment or during surveillance and control activities. But you are also more likely to fall if you have to get out of bed to go to the toilet at night.
Rarely (affects 1 to 10 in 100 people), especially during the first weeks of use
- Impaired coordination . This may make you clumsy in your movements and have difficulty speaking (articulating) clearly.
- Muscle weakness and feeling of weakness in muscles . This side effect can cause the following other complaints.
Blurred or double vision due to a temporary effect on the eye muscles.
Difficulty controlling urination ( incontinence ) or difficulty passing urine. These side effects are caused by insufficient control of the bladder muscle.
Snoring due to the weakening of the uvula. During your sleep, have you ever had problems with your breath stopping for a short time ( sleep apnea )? You may be more affected by this medicine. Contact your doctor if you notice this.
Fallespecially because this drug also decreases coordination. Especially the elderly and people with muscle diseases have a chance of this.
- People with myasthenia gravis (a serious muscle disease) may be more prone to this disease. Consult your doctor if the symptoms worsen (such as general muscle weakness, double vision, closing eyelids, difficulty swallowing, chewing or breathing).
- Slower thinking , memory problems, difficulty concentrating, less alert and confused (confusion). These complaints may increase if you use this medicine for a longer period of time.
- Decrease in feelings. This drug not only flattens emotions such as fear and tension, but also positive ones such as happiness and satisfaction. Your involvement and empathy for others can also diminish.
Rare (affects 1 to 10 in 100 people)
- Gastrointestinal disorders , such as nausea, constipation and diarrhea, dry mouth or extra saliva, and problems with swallowing, and an altered appetite, namely more or less appetite. This also changes body weight.
- Headache and dizziness. These side effects usually go away after some time as you get used to the drug.
- Sweating and palpitations .
- Dry eyes. Especially people with contact lenses can suffer from dry eyes.
- Rash and itching . Usually this is harmless , but (very rarely) the symptoms can be serious. If the rash looks unusual, if it affects you, or if you also develop a fever or blisters, see your doctor.
- Dependence. You may experience withdrawal symptoms if you stop taking it. The chance of this is very small with short-term use. People who use this drug for more than two months in a row have a high chance of this. Therefore, always taper off gradually if you have been taking this medicine for more than two months.
Very rare (affects less than 1 in 100 people)
- Vivid dreams or nightmares, usually in the early morning.
- Unrest and irritability . So opposite symptoms than you would expect from this drug. You may also start to believe or think things that are not correct ( delusions ) and see, hear or feel things that are not there ( hallucinations ) . Children and the elderly are especially sensitive to these side effects. Consult the doctor in case of these symptoms. A lower dose or a different drug may be needed.
- Memory loss of events that occur while you are taking this drug. For example, night events.
- Depressed feelings can be revealed.
- Less sex drive .
- Trouble breathing . Respiratory complaints may increase in people with the lung disease COPD . Discuss this with your doctor.
Consult your doctor if you are experiencing too much of any of the above side effects or if you are experiencing other side effects that you are concerned about.
- Regular : affects more than 30 in 100 people
- Uncommon : affects 10 to 30 in 100 people
- Rare : affects 1 to 10 in 100 people
- Very rare : affects less than 1 in 100 people
Look for the correct dosage on the label of the pharmacy.
- Divide the tablets evenly throughout the day. So at 3 times a day every 8 hours.
- Do you only use this medicine in special cases, such as with fear of flying? Then take it about 1 hour in advance.
Feeling anxious and tense.
- Use for longer than 2 months in a row is strongly discouraged. There is too much chance that you will become dependent on this medicine. This means that when you stop taking it, you will get withdrawal symptoms.
- Also try to reduce your anxiety and tension in another way. Ask your doctor for advice. Are you taking this drug with an antidepressant? In that case, you are usually supposed to taper off within a few weeks, because then the antidepressant will start to work.
Panic disorder, social phobia or general anxiety disorder
- After 3 months it should be clear whether this medicine is working well for you. The treatment often takes six months to a year. Then you should taper the dose for 3 months.
It is not harmful if you miss a dose . However, if you have been on the drug for several weeks, you will have become accustomed to it and may experience withdrawal symptoms with the forgotten tablet.
- Are you used to taking a tablet 2 or 3 times a day , and have you forgotten one? Never take a double dose . You can, however, catch up with the tablet if you take the next tablet at least 3 hours later.
- If you are taking this medicine once a day , will it be more than 8 hours before you normally take the next dose ? Then take the forgotten dose . Does it take less than 8 hours? Then skip the forgotten dose .
driving a car?
It can be dangerous to participate in traffic while taking this medicine. Do you want to know whether you can drive a car with this medicine? Then answer the questions in the diagram below.
Note: severe panic attacks can also be a reason that you are not allowed to drive. Consult with your doctor if this is the case for you. Would you like more information about driving with certain diseases? Then take a look at the website of the CBR .
For more general information you can read the topic ‘ Medicines in traffic ‘. In this theme you can read, for example, what the law says about medicines in traffic. You will also find advice that you should take into account if you are allowed to drive (again).
- Limit the use of alcohol and avoid drinking it.
- This medicine makes you react much more strongly to alcohol than you are used to.
- In addition, alcohol increases the side effects of this drug, such as drowsiness and reduced coordination .
- There are no restrictions for this with this medication.
This drug interacts with other drugs. The text below only lists the active ingredients of these drugs, not the brand names. You can check whether your medicine contains one of these active substances in your package leaflet under the heading ‘composition’.
The drugs with which the main interactions occur are the following.
- Other drugs that reduce reaction time. These medicines often have a yellow warning sticker on the packaging . The effects on responsiveness and coordination capacity are mutually reinforcing. Then alprazolam can work for longer than three days. For example, you can no longer drive a car.
- Some medicines for HIV (virus that can give you AIDS ) . Ask your pharmacist which medicines this concerns.
- Some medicines for hepatitis C (inflammation of the liver). Ask your pharmacist which medicines this concerns.
- Some cancer drugs . Ask your pharmacist which medicines this concerns. The effects or side effects of these drugs may change. Discuss this with your doctor.
The following medications can increase the amount of alprazolam in the blood. This makes the effect and side effects, such as drowsiness, stronger. Consult your doctor if you have been prescribed this combination. They may be able to prescribe you a drug that does not interact with this.
- The antidepressant fluvoxamine .
- The medicines for cardiovascular disease verapamil and diltiazem.
- The antibiotics erythromycin and clarithromycin.
- The anti- fungal medicines itraconazole, ketoconazole, fluconazole, posaconazole and voriconazole.
- The stomach medicine cimetidine .
The following medicines reduce the effect of alprazolam. Your doctor will need to take this into account when determining the dose . The doctor may be able to prescribe a drug that does not interact with this.
- The epilepsy drugs phenytoin, carbamazepine, barbiturates such as phenobarbital and primidone. Some of these drugs are also used for pain caused by damage to a nerve ( nerve pain ) or manic depression .
- The tuberculosis drugs rifabutin and rifampin.
- St. John’s wort (hypericum), a herbal remedy for depressive symptoms. Consult with your doctor.
Not sure if any of the above interactions are of interest to you? Please contact your pharmacist or doctor.
- Report it to your doctor and pharmacist as soon as you are pregnant. Or if you want to become this soon. When used for a long time during the last 3 months of pregnancy (3rd trimester), withdrawal symptoms may develop in the baby. And when used at a high dose just before delivery, your child may be so dazed and floppy after birth that it has difficulty breathing.
- Therefore, only use this medicine if it is really necessary. And as short as possible in a low dose . Weigh the severity of your illness against the risk to the child with your doctor. You may be able to (temporarily) use a different medication.
- If you want to breast-feed, talk to your doctor or pharmacist. This drug passes into breast milk. It can then cause side effects in the child. Your doctor may be able to (temporarily) prescribe you a different medication.
If you have only been using this drug for a few days in a row, you can stop at one time. In general, withdrawal symptoms will not occur.
Have you used it for a long time? Then the following information is important to you.
- After several weeks to months of use, you may have gotten used to the feeling that this medicine makes you feel. For example, you only dare to leave the house with the medicine. If you notice this, please contact your doctor for advice on tapering off.
- After a few weeks to months of use, you should taper off slowly. If you stop suddenly, you may have withdrawal symptoms within a few days. For example palpitations , insomnia, anxiety, irritability, a rushed feeling, muscle cramps, tremors and hypersensitivity to light, sound and touch.
- These withdrawal symptoms are difficult to distinguish from symptoms of anxiety and tension. It then seems as if the complaints for which you originally received this medicine are coming back. Do not start again with the drug, but try to get rid of your complaints in a different way. Otherwise you run the risk of ending up in a vicious circle.
- If you reduce the dose over a few weeks to months, you will have no or less withdrawal symptoms. Ask your doctor or pharmacist for advice on a good tapering schedule . Sometimes it is better to switch to a different sedative first, which is easier to taper off.
Alprazolam has been on the market internationally since 1983. It is available by prescription in tablets under the brand names Xanax and as the unbranded Alprazolam.