Alprazolam is used to relieve symptoms of anxiety, including anxiety caused by depression. It is also used to treat panic disorder in some patients.

Alprazolam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor's prescription.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the extended-release tablet or tablet whole with a full glass of water. Do not break, crush, or chew it.

If you are using the orally disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not remove the tablets from the bottle until you are ready to take it. Place the tablet immediately on the top of your tongue. It should melt quickly and be swallowed with saliva.

If you are using the oral liquid, measure the dose with a marked measuring spoon, oral syringe, or medicine cup.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Being forgetful

changes in patterns and rhythms of speech

clumsiness or unsteadiness

difficulty with coordination

discouragement

drowsiness

feeling sad or empty

irritability

lack of appetite

lightheadedness

loss of interest or pleasure

relaxed and calm

shakiness and unsteady walk

sleepiness or unusual drowsiness

slurred speech

tiredness

trouble concentrating

trouble performing routine tasks

trouble sleeping

trouble speaking

unsteadiness, trembling, or other problems with muscle control or coordination

unusual tiredness or weakness

Less common

Abdominal or stomach pain

blurred vision

body aches or pain

burning, crawling, itching, numbness, prickling, "pins and needles, or tingling feelings

changes in behavior

chills

clay-colored stools

confusion about identity, place, and time

cough

dark urine

decrease in frequency of urination

decrease in urine volume

diarrhea

difficult or labored breathing

difficulty in passing urine (dribbling)

difficulty with concentration

difficulty with moving

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

dry mouth

ear congestion

environment seems unreal

fainting

fear or nervousness

feeling of unreality

feeling warm

fever

general feeling of discomfort or illness

headache

hyperventilation

inability to move the eyes

inability to sit still

increased blinking or spasms of the eyelid

irregular heartbeats

itching or rash

joint pain

lack or loss of self-control

loss of bladder control

loss of coordination

loss of memory

loss of voice

mood or mental changes

muscle aching or cramping

muscle pain or stiffness

muscle weakness

nasal congestion

nausea

need to keep moving

painful urination

problems with memory

restlessness

runny nose

seeing, hearing, or feeling things that are not there

seizures

sense of detachment from self or body

shaking

shivering

sneezing

sore throat

sticking out of the tongue

sweating

swollen joints

talkativeness

tightness in the chest

trouble with balance

twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

uncontrolled twisting movements of the neck, trunk, arms, or legs

unpleasant breath odor

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

unusual facial expressions

unusually deep sleep

unusually long duration of sleep

vomiting of blood

yellow eyes or skin

Rare

Actions that are out of control

attack, assault, or force

chest pain

continuing ringing or buzzing or other unexplained noise in the ears

decreased awareness or responsiveness

deep or fast breathing with dizziness

ear pain

false or unusual sense of well-being

fast, irregular, pounding, or racing heartbeat or pulse

feeling jittery

feeling unusually cold

generalized slowing of mental and physical activity

hearing loss

hoarseness

lack of feeling or emotion

loss of control of the legs

loss of strength or energy

nightmares

numbness of the feet, hands, and around mouth

severe sleepiness

shakiness in the legs, arms, hands, or feet

sleep talking

swelling

talking, feeling, and acting with excitement

thoughts of killing oneself

uncaring

unusual weak feeling

voice changes

Incidence not known

General tiredness and weakness

light-colored stools

stomach pain, continuing

upper right abdominal or stomach pain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Absent, missed, or irregular menstrual periods

decreased appetite

decreased interest in sexual intercourse

decreased sexual performance or desire abnormal ejaculation

difficulty having a bowel movement (stool)

inability to have or keep an erection

increased appetite

increased in sexual ability, desire, drive, or performance

increased interest in sexual intercourse

increased weight

loss in sexual ability, desire, drive, or performance

stopping of menstrual bleeding

watering of the mouth

weight loss

Less common

Abdominal or bloating and cramping

blistering, crusting, irritation, itching, or reddening of the skin

change in taste bad unusual or unpleasant (after) taste

cracked, dry, or scaly skin

cramps

double vision

feeling of warmth

heavy bleeding

menstrual changes

pain

pelvic pain

redness of the face, neck, arms, and occasionally, upper chest

seeing double

sudden sweating

unexplained runny nose or sneezing

Rare

Acid or sour stomach

belching

bigger, dilated, or enlarged pupils (black part of the eye)

change in color vision

difficulty seeing at night

feeling of constant movement of self or surroundings

feeling of relaxation

heartburn

hives or welts

increased sensitivity of the eyes to sunlight

indigestion

redness of the skin

runny nose

sensation of spinning

stomach discomfort, upset, or pain

stuffy nose

Incidence not known

Blistering, peeling, or loosening of the skin

red, irritated eyes

red skin lesions, often with a purple center

sores, ulcers, or white spots in the mouth or on the lips

swelling of the breasts or breast soreness in both females and males

unexpected or excess milk flow from the breasts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not take itraconazole (Sporanox®) or ketoconazole (Nizoral®) while you are using this medicine. Using any of them together with this medicine may increase the chance of serious side effects.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or seizure medicines, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop using this medicine. Check with your doctor before taking any of the above while you are using this medicine.

If you develop any unusual and strange thoughts or behavior while you are taking alprazolam, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

Alprazolam may cause some people, especially older persons, to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy, or are not alert or able to see well.

Do not stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, such as convulsions (seizures), stomach or muscle cramps, sweating, tremors, vomiting, or unusual behavior.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.