Xanax is a brand-name oral tablet that’s prescribed for certain anxiety disorders. Xanax contains the active drug alprazolam and belongs to the benzodiazepine drug class.
Xanax is FDA-approved to treat the following in adults:
- generalized anxiety disorder
- panic disorder, with or without agoraphobia (fear of being in places where it may be hard to leave)
Drug details
You’ll find key information about Xanax below.
- Drug form: Oral tablet
- Generic available? Yes
- Prescription required? Yes
- Controlled substance? Yes*
- Year of FDA approval: 1981
* For more information, see “Is Xanax a controlled substance?” in the “Xanax misuse and addiction” sections below.
Xanax vs. Xanax XR
Another form of Xanax is available. It’s called Xanax XR, and it’s approved to treat only panic disorder.
Xanax tablets are immediate release, which means all the medication is released as soon as the tablet dissolves. Xanax XR tablets are extended release (XR). This means the drug is released slowly over time.
To treat panic disorder, you’ll likely take Xanax three times per day. Xanax XR works over about 24 hours, so you’ll likely take a dose once per day. Your doctor may prescribe Xanax XR if once-daily dosing is more convenient for you. They may also prescribe this form if your panic disorder symptoms come back or worsen between doses of immediate-release Xanax.
This article focuses just on Xanax. To learn more about Xanax XR, talk with your doctor.
Xanax can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Xanax. These lists do not include all possible side effects.
For more information about the possible side effects of Xanax, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may concern or bother you.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Xanax, you can do so through MedWatch.
Mild side effects
Mild side effects* of Xanax can include:
- memory loss
- constipation
- hypotension (low blood pressure)
- dry mouth
- drowsiness
- dizziness or lightheadedness
- problems with balance or coordination
- trouble concentrating
- trouble speaking clearly
- changes in sex drive
- changes in appetite
- weight changes
- mild allergic reaction†
Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or do not go away, talk with your doctor or pharmacist.
* This is a partial list of mild side effects of Xanax. To learn about other mild side effects, talk with your doctor or pharmacist, or view Xanax’s prescribing information.
† For additional information about allergic reaction, see “Allergic reaction” below.
Serious side effects
Serious side effects from Xanax are not common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
- Reduced ability to drive safely or perform other potentially dangerous activities. Symptoms can include:
- sleepiness
- dizziness or lightheadedness
- reduced alertness
- trouble concentrating
- slowed reaction times
- Liver problems. Symptoms can include:
- abdominal pain
- nausea and vomiting
- increased levels of liver enzymes (types of proteins)
- jaundice
- Seizures. Symptoms can vary depending on the type of seizure but may include:
- shaking or jerking movements
- stiffness or floppiness
- confusion
- Hallucinations (sensing things that are not really there). Symptoms can include:
- hearing something that’s not present, such as a voice talking to you
- seeing something that’s not real, such as lights or people
- Risk of misuse and addiction.*†
- Risk of dependence and withdrawal.*‡
- Risk of severe harm or death if taken with opioids.*§
- Severe allergic reaction.¶
* Xanax has a
† To learn more, see the “Xanax misuse and addiction” section below.
‡ For more information, see the “Xanax dependence and withdrawal” section below.
§ For details, see the “Xanax precautions” section below.
¶ For additional information about allergic reaction, see “Allergic reaction” below.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Xanax. This side effect was not reported in clinical trials of this drug but has occurred since the drug was approved.
Symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing
Call your doctor right away if you have an allergic reaction to Xanax, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
The Xanax dosage your doctor prescribes will depend on several factors. These include:
- the condition you’re taking Xanax to treat and its severity
- your age
- the form of Xanax you take*
- your liver function
- other medical conditions you may have
- other medications you may take
- side effects you may have with Xanax
Xanax doses are not determined by weight.
Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
For more details on the dosage of Xanax, see this article.
* Xanax also comes in a form called Xanax XR. To learn more, see the “What is Xanax?” section above.
Xanax form and strengths (0.25 mg, 0.5 mg, 1 mg, and 2 mg)
Xanax comes as an oral tablet that’s available in four strengths: 0.25 milligrams (mg), 0.5 mg, 1 mg, and 2 mg.
Xanax tablet colors: White, peach, or blue
The color and shape of Xanax tablets vary by strength:
- 0.25 mg: white, oval
- 0.5 mg: peach, oval
- 1 mg: blue, oval
- 2 mg: white, rectangle with rounded corners
Xanax also comes as a long-acting form called Xanax XR (extended-release). Xanax XR tablets come in the following strengths, colors, and shapes:
- 0.5 mg: white, pentagon
- 1 mg: yellow, square
- 2 mg: blue, round
- 3 mg: green, triangle
To learn more about dosages of Xanax XR, talk with your doctor.
Dosage for generalized anxiety disorder
To treat generalized anxiety disorder (GAD) in adults, the typical starting dosage of Xanax is 0.25 mg to 0.5 mg, three times per day.
It’s possible that your doctor will adjust your dose every 3 to 4 days until you’re taking the dose that’s right for you. This depends on how you respond to the starting dosage.
The maximum recommended dosage for GAD is 4 mg per day, split into three doses.
Dosage for panic disorder
To treat panic disorder in adults, the recommended starting dosage of Xanax is 0.5 mg three times per day.
It’s possible that your doctor will adjust your dose every 3 to 4 days until you’re taking the dose that’s right for you. This depends on how you respond to the starting dosage. Your dose should be increased by no more than 1 mg per day.
The average dosage for panic disorder is 5 mg to 6 mg per day, split into three doses. However, some people may need up to 10 mg per day, split into three doses.
What if I miss a dose?
If you miss a dose of Xanax, take it as soon as you remember. But if it’s nearly time for your next dose, skip the missed dose and just take your next dose as scheduled. You should not take a double or extra doses to make up for missing a dose. Doing so can cause serious side effects. (For more information about side effects, see the “Xanax side effects” section above.)
To help make sure that you do not miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
Will I need to take this drug long term?
Xanax is not meant to be a long-term treatment. Your doctor will typically prescribe it for as short a time as possible.
It’s unknown if it’s safe or effective to take Xanax for longer than 4 months for GAD. And it’s unknown if it’s safe or effective to take the drug for longer than 10 weeks for panic disorder.
When you and your doctor agree that you should stop taking Xanax, your doctor will reduce your dose slowly. This helps avoid withdrawal symptoms you may have if you suddenly stop treatment.*
* Xanax has a
Xanax is a brand-name drug that contains the active drug alprazolam. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.
Generic alprazolam comes as a tablet, extended-release tablet, orally disintegrating tablet, and oral liquid concentrate.
The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.
If you’re interested in the generic form of Xanax, talk with your doctor. They can tell you if it comes in forms and strengths that can be prescribed for your condition.
You may wonder how Xanax compares with other medications that are prescribed for similar purposes, such as Ativan.
Xanax and Ativan may be used to treat anxiety symptoms, although the drugs also have other uses that differ. Both drugs come in oral tablet form. (Ativan also comes as an injection, but this form is not used to treat anxiety symptoms.)
The active drug in Xanax is alprazolam, while the active drug in Ativan is lorazepam.
For more details about how Xanax compares with Ativan, see this article.
You may be curious about how Xanax compares with other medications that are prescribed for similar purposes, such as buspirone.
Xanax and buspirone may be used to treat generalized anxiety disorder. These drugs also have other uses that differ. Both come as oral tablets.
These medications contain different active drugs. The active drug in Xanax is alprazolam, and the active drug in buspirone is buspirone.
For more details about how Xanax compares with buspirone, see this article.
Here are answers to some frequently asked questions about Xanax.
Would my doctor prescribe Xanax for depression, sleep problems, or other conditions?
Maybe. Xanax is approved to treat only generalized anxiety disorder and panic disorder. However, your doctor might sometimes prescribe Xanax off-label for certain other uses. These include short-term treatment of temporary anxiety symptoms. For example, Xanax might be prescribed off-label for anxiety associated with:
- depression
- fear of flying
- pain
- obsessive-compulsive disorder (OCD)
- post-traumatic stress disorder (PTSD)
Xanax may also sometimes be prescribed off-label for sleep problems. The medication works quickly, so it can help you fall asleep if you have trouble doing so. However, doctors prescribe Xanax only in certain circumstances because your sleep problems may come back when you stop taking the drug.
If you have additional questions about an off-label use of Xanax, talk with your doctor.
Is Xanax a narcotic?
No, Xanax is not a narcotic. Xanax is a type of drug called a benzodiazepine.
Narcotics are opioids, which are drugs related to the opium poppy. Examples include strong prescription pain relievers, such as morphine (MS Contin) and oxycodone (OxyContin, Xtampza ER, Oxaydo, others).
Xanax has a
Your doctor and pharmacist can help answer other questions you have.
Is it safe to take Xanax with Adderall?
Xanax is not known to interact with amphetamine/dextroamphetamine (Adderall). However, taking these medications together may not be safe.
Adderall is a stimulant medication that’s prescribed for the treatment of attention deficit hyperactive disorder (ADHD). Doctors may sometimes prescribe Xanax with Adderall for people with ADHD who also have anxiety. Taking these medications together for this purpose as prescribed by a doctor is not known to be harmful.
However, both Xanax and Adderall have a risk of misuse.* Misuse refers to taking a drug for a purpose or in a way that a doctor has not prescribed. If Xanax is misused with Adderall, this may increase the risk of serious outcomes. These may include serious side effects, overdose, and addiction. (For more information about side effects, see the “Xanax side effects” section above.)
You should take Xanax with Adderall only if your doctor has prescribed them. They can tell you more.
* Xanax has a
Can I take a pain reliever such as Tylenol during Xanax treatment?
Yes, it’s typically safe to take a mild pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), while you’re taking Xanax.
However, not all pain relievers are safe to take with Xanax. For example, pain relievers that contain opioids can cause severe side effects and, in rare cases, death if taken with Xanax.* Examples of opioids include codeine, hydrocodone (Hysingla ER), and oxycodone (OxyContin, Xtampza ER, Oxaydo).
It’s important to note that some pain-relieving drugs contain acetaminophen in combination with an opioid. Examples include:
- acetaminophen/oxycodone (Percocet, Oxycet)
- acetaminophen/hydrocodone
- acetaminophen/dihydrocodeine (Trezix)
You should not take pain relievers that contain an opioid with Xanax unless your doctor has approved it. If you need a pain reliever during Xanax treatment, ask your doctor or pharmacist to recommend a suitable medication.
* Xanax has a boxed warning about the risk of severe harm or death if taken with opioids. A boxed warning is the most serious warning from the FDA. For more details, see the “Xanax precautions” section below.
What’s a half-life chart, and does Xanax have one?
A half-life chart can show you the amount of a dose that may still be in your system after a certain amount of time. Your doctor or pharmacist may be able to describe what a half-life chart for Xanax would look like.
The half-life of a drug is the length of time it takes for half a dose of the drug to be removed from your body. It typically takes between
Xanax has a half-life of about 11 hours. This means it takes about 2.5 days for Xanax to be fully removed from your body. However, the exact amount of time you’ll have Xanax in your system depends on various factors. These include your age, liver function, and other medications you may take.
You can reach out to your doctor or pharmacist if you have additional questions.
Can stopping Xanax treatment cause a hangover-like feeling?
It might. Stopping Xanax treatment can sometimes cause withdrawal symptoms* as the effects of the medication wear off. This can cause symptoms similar to those you might have with an alcohol hangover. For example, you may have a headache, nausea, or vomiting. You may also feel anxious or irritable.
You’re more likely to have withdrawal symptoms after stopping Xanax treatment if you’ve been taking the drug for a long time or at a high dose. However, these symptoms can also affect anyone who stops taking Xanax.
To help reduce your risk of withdrawal symptoms, your doctor will gradually reduce your dose when you stop taking Xanax. If you have hangover-like symptoms when stopping Xanax treatment, talk with your doctor. They can recommend ways to help ease the symptoms.
* Xanax has a boxed warning about the risk of dependence and withdrawal. A boxed warning is the most serious warning from the FDA. To read more about this, see “Xanax dependence and withdrawal” below.
The Food and Drug Administration (FDA) approves prescription drugs such as Xanax to treat certain conditions. Xanax may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.
Xanax for generalized anxiety disorder
Xanax is FDA-approved for the short-term treatment of generalized anxiety disorder (GAD) in adults.
Generalized anxiety disorder explained
GAD is a mental health condition that can affect your daily life and impact your relationships with others.
It’s common to have anxiety about the stresses of everyday life. However, with GAD, you have ongoing anxiety about everyday life that’s excessive and out of proportion.
Symptoms of GAD may include:
- excessive, uncontrollable, long lasting worries or fears
- intrusive thoughts or trouble concentrating
- trouble sleeping
- restlessness
- fatigue
- irritability
- tense muscles
- nausea
- diarrhea
- heart palpitations
- sweating
Xanax is a benzodiazepine drug that has a calming and relaxing effect. Doctors usually prescribe it for short periods of time. It’s typically used to help ease the symptoms of anxiety while other treatments for GAD, such as antidepressants, are taking effect.
Effectiveness for generalized anxiety disorder
Xanax is an effective medication for relieving anxiety. To find out how the drug performed in clinical trials, see Xanax’s prescribing information.
Benzodiazepines such as Xanax are included in guidelines for managing GAD. The drugs are recommended for short-term treatment to help ease anxiety symptoms.
You can learn more about your condition in our anxiety hub and mental health hub.
Xanax for panic disorder
Xanax is FDA-approved to treat panic disorder, with or without agoraphobia, in adults.
Panic disorder explained
Panic disorder is a common mental health condition that can affect your daily life and impact your relationships with others. It’s a type of anxiety disorder.
With panic disorder, you have unexpected and recurrent panic attacks. A panic attack is an intense feeling of fear that comes on suddenly. It may cause symptoms such as:
- shaking
- dizziness
- nausea
- pounding heartbeat
- chest pain
- sweating
- trouble breathing
- choking sensation
With panic disorder, you become afraid of having more panic attacks. This can make you avoid situations or places you feel may trigger a panic attack. This can lead to agoraphobia.
Agoraphobia is an intense and irrational fear of situations where you think you might have trouble leaving or getting help if you have a panic attack. For example, you may be afraid of being in a crowd or in open or enclosed spaces. You may also be afraid of using public transportation or leaving your home alone.
Xanax is a benzodiazepine drug that has a calming and relaxing effect. Doctors usually prescribe it for short periods of time. Xanax is typically used to help ease panic attacks while other treatments for panic disorder, such as antidepressants, take effect.
Effectiveness for panic disorder
Xanax is an effective medication for reducing the number of panic attacks you have. To find out how the drug performed in clinical trials, see Xanax’s prescribing information.
Benzodiazepines such as Xanax are included in guidelines for managing panic disorder. The drugs are recommended for short-term treatment to help reduce the frequency of panic attacks.
You can learn more about your condition in the MNT anxiety hub and mental health hub.
Xanax and children
Xanax is not FDA-approved for any use in children. It’s unknown if Xanax is safe or effective in children.
Your doctor may prescribe Xanax with other drugs for generalized anxiety disorder or panic disorder.
Xanax is typically prescribed for short periods of time to relieve anxiety symptoms while other treatments, such as antidepressants, are taking effect. Antidepressants can take about 4 to 6 weeks to start working for anxiety disorders.
Examples of antidepressants that may be prescribed with Xanax include:
- selective serotonin reuptake inhibitors (SSRIs), such as:
- serotonin-norepinephrine reuptake inhibitors (SNRIs), such as:
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
Xanax can interact with several other medications. It can also interact with certain supplements as well as certain foods.
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe. Drug-condition interactions can also cause certain effects. For information about these interactions, see the “Xanax precautions” section below.
Xanax and other medications
Below is a list of medications that can interact with Xanax. This list does not contain all drugs that may interact with Xanax.
Before taking Xanax, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Types of drugs that can interact with Xanax include:
- Opioids. Opioids are powerful drugs that are also known as opiates or narcotics. They include strong prescription pain relievers and certain illegal drugs. Taking Xanax with opioids can lead to severe harm and, in rare cases, death.* Due to these risks, doctors will typically not prescribe Xanax with opioids unless there are no other suitable treatment options. Examples of opioids include:
- Strong CYP3A inhibitors. Taking Xanax with drugs that are strong cytochrome P450 3A (CYP3A) inhibitors can increase the risk of side effects from Xanax.‡ Due to this risk, doctors typically will not prescribe Xanax with strong CYP3A inhibitors, except ritonavir (Norvir). Examples of these drugs include:
- clarithromycin
- ketoconazole
- itraconazole (Sporanox, Tolsura)
- Weak or moderate CYP3A inhibitors. Taking Xanax with drugs that are weak or moderate CYP3A inhibitors can increase the risk of side effects from Xanax.‡ If you need to take Xanax with one of these medications, your doctor will likely prescribe a Xanax dosage that’s lower than usual. Examples of weak or moderate CYP3A inhibitors include:
- cimetidine (Tagamet HB)
- erythromycin (Eryc, Ery-Tab, others)
- fluvoxamine (Luvox)
- nefazodone
- Strong CYP3A inducers. Taking Xanax with drugs that are CYP3A inducers can make Xanax less effective. Examples of these drugs include:
- carbamazepine (Tegretol, Carbatrol, Equetro, others)
- phenytoin (Dilantin)
- Ritonavir. Ritonavir (Norvir) is a drug used to treat HIV. Ritonavir can affect the breakdown of Xanax in your body. Your doctor may adjust your Xanax dosage if you take the drug with ritonavir.
- Digoxin. Digoxin (Lanoxin) is a heart medication. Taking Xanax with digoxin may cause digoxin to build up in your body. Your doctor may monitor your digoxin level and reduce your digoxin dosage if needed.
- CNS depressants. Xanax is a type of drug called a central nervous system (CNS) depressant. Taking Xanax with other CNS depressants may cause excessive sleepiness and breathing problems. If you need to take Xanax with one of these drugs, your doctor will likely prescribe a Xanax dosage that’s lower than usual. Examples of CNS depressants include:
- certain antidepressants, such as amitriptyline, trazodone, and mirtazapine (Remeron)
- certain antipsychotics, such as haloperidol (Haldol) and risperidone (Risperdal)
- certain seizure medications, such as gabapentin (Neurontin) and topiramate (Topamax)
- certain muscle relaxants, such as carisoprodol (Soma) and cyclobenzaprine (Amrix)
- sedating antihistamines, such as chlorpheniramine and promethazine
- sleeping pills, such as zolpidem (Ambien) and zaleplon (Sonata)
* Xanax has a
† Heroin is illegal for personal use in the United States, and Medical News Today does not support taking illegal substances. However, we do support access to important health information. This interaction is mentioned to help you stay safe during Xanax treatment.
‡ For more information about side effects, see the “Xanax side effects” section above.
Xanax and herbs and supplements
Here’s some information about herbs, supplements, and Xanax treatment. Be sure to talk with your doctor before taking any herbs or supplements with Xanax.
St. John’s wort
Taking Xanax with the herb St. John’s wort may lower the level of Xanax in your body. This could make Xanax less effective than usual.
St. John’s wort is often used to treat depression. If you’re taking this herb, talk with your doctor. They can advise you on the right treatments for you.
Cannabis
Cannabis is often known as marijuana or “weed.” Taking Xanax with cannabis could increase the risk of side effects from Xanax, especially sleepiness. Due to this interaction, doctors will typically advise that you do not take Xanax with cannabis.
For more information about side effects of Xanax, see the “Xanax side effects” section above. To learn more about cannabis and the drug, talk with your doctor.
Xanax and foods
Consuming grapefruit or grapefruit juice while taking Xanax could increase your risk of side effects from Xanax. It’s best to avoid consuming grapefruit products while taking Xanax.
For more information about side effects of Xanax, see the “Xanax side effects” section above. If you have questions about consuming other foods with Xanax, talk with your doctor.
If you drink alcohol, it’s best to avoid drinking it while taking Xanax. Alcohol and Xanax can reduce the activity of your central nervous system (CNS). So consuming alcohol with Xanax can lower the activity further.
The CNS refers to the brain and spinal cord. This system helps regulate breathing, actions, thinking, and more.
Drinking alcohol with Xanax can increase your risk of side effects such as:
- drowsiness
- dizziness or lightheadedness
- problems with balance or coordination
- trouble concentrating
- trouble speaking clearly
- memory loss
- slowed reaction time
- breathing problems
- coma
Consuming alcohol during Xanax treatment can also increase your risk of an overdose from Xanax and, in rare cases, death. If you feel you need help avoiding alcohol while taking Xanax, talk with your doctor.
Xanax has a
About misuse and addiction
Misuse refers to taking a drug for a purpose or in a way that a doctor has not prescribed. People often misuse drugs to produce a pleasurable, calm, or high feeling. Misuse can lead to addiction, which is when you’re unable to stop taking a drug, even though it may be causing harm.
Symptoms of Xanax misuse or addiction may include:
- taking Xanax more often or in higher doses than prescribed
- craving Xanax
- spending a lot of time trying to obtain Xanax
- having health, personal, social, work, or relationship problems due to Xanax
About Xanax misuse and addiction
Xanax misuse and addiction can lead to serious side effects, including breathing problems, seizures, paranoia, and suicidal thoughts or actions. Xanax misuse and addiction can also lead to overdose and, in rare cases, death. This is especially the case if Xanax is taken with alcohol, illegal drugs, or other medications (especially opioids*).
If you’ve had problems with drug or alcohol misuse or addiction in the past, you may have an increased risk of these problems with Xanax. Your doctor will assess your risk of misuse and addiction before determining whether Xanax is right for you.
You should take Xanax exactly as prescribed by your doctor. It’s important that you do not increase your dose or take more than prescribed unless you first talk with your doctor. Also, be sure to contact your doctor as soon as possible if you have any symptoms of misuse or addiction, or any concerns about them.
* Xanax has a boxed warning about the risk of severe harm or death if taken with opioids. To learn more, see the “Xanax precautions” section below.
Is Xanax a controlled substance?
Yes, Xanax is classified as a Schedule IV controlled substance. This means the medication has an accepted medical use, but it also has a risk of misuse and dependence.*
With dependence, your body becomes reliant on a drug to function as usual. If you suddenly stop taking a drug that your body has become dependent on, you could experience side effects known as withdrawal symptoms.
There are special rules around prescribing and supplying Schedule IV controlled drugs. Your doctor or pharmacist can tell you more about this.
* Xanax has a
Other drugs like Xanax are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Xanax, talk with your doctor. They can tell you about other medications that may work well for you. This could include other benzodiazepines. (Xanax is a type of drug called a benzodiazepine.)
Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than what it’s approved for.
Alternatives for generalized anxiety disorder
Examples of other drugs that a doctor may prescribe for generalized anxiety disorder include:
- buspirone (Buspar)*
- pregabalin (Lyrica)
- other benzodiazepines such as:
- SSRI antidepressants, such as:
- SNRI antidepressants, such as:
- venlafaxine (Effexor XR)
- duloxetine (Cymbalta)
- tricyclic antidepressants, such as:
- amitriptyline
- imipramine (Tofranil)
* Buspar, the brand-name version of buspirone, is no longer available.
Alternatives for panic disorder
Examples of other drugs that may be prescribed for panic disorder include:
- other benzodiazepines such as:
- clonazepam (Klonopin)
- lorazepam (Ativan)
- SSRI antidepressants such as:
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
- sertraline (Zoloft)
- SNRI antidepressants such as:
- venlafaxine (Effexor XR)
- tricyclic antidepressants such as:
- amitriptyline
- imipramine (Tofranil)
You may wonder how Xanax compares with other medications that are prescribed for similar purposes, such as Valium.
Xanax and Valium may be used to treat anxiety disorders, although both drugs have other uses that differ. These drugs come as oral tablets.
The active drug in Xanax is alprazolam, while the active drug in Valium is diazepam.
For more details about how Xanax compares with Valium, see this article.
You may be curious about how Xanax compares with other drugs that are prescribed for similar purposes, such as clonazepam.
Xanax and clonazepam may be used to treat panic disorder, and these drugs have other uses that differ. Both come as oral tablets, but clonazepam also comes as an orally disintegrating tablet.
These medications contain different active drugs. The active drug in Xanax is alprazolam, while the active drug in clonazepam is clonazepam. (Clonazepam is also available as the brand-name drug Klonopin.)
To learn more about how Xanax is similar to and different from clonazepam, you can refer to this article.
Xanax has a
With dependence, your body becomes reliant on a drug to function as usual. If you suddenly stop taking a drug that your body has become dependent on, you could experience side effects known as withdrawal symptoms.
Note: Xanax is classified as a Schedule IV controlled substance because it has a risk of misuse and dependence. For more information, see “Is Xanax a controlled substance?” in the “Xanax misuse and addiction” section above.
Symptoms of withdrawal
Suddenly “coming off” Xanax can cause serious or even life threatening withdrawal symptoms. These may include:
- withdrawal seizure
- hallucinations (seeing or hearing things that are not really there)
- psychosis (loss of touch with reality)
- mania (state of heightened energy)
- suicidal thoughts or actions
Other withdrawal symptoms associated with coming off Xanax may include:
- headache
- anxiety
- depression
- irritability
- problems with thinking, understanding, or memory
- dizziness
- fatigue
- insomnia
- nausea and vomiting
- diarrhea
- muscle twitching
- tremor
- tingling or burning sensations
- hearing problems such as increased sensitivity to noise or ringing in your ears
Certain withdrawal symptoms may sometimes last for several weeks or months.
You may have an increased risk of dependence and withdrawal if you take more than 4 milligrams (mg) of Xanax per day. You may also have an increased risk if you take Xanax for a long period of time. However, these problems are also possible with lower doses and after taking the drug for a short time.
Talking with your doctor
To help avoid withdrawal symptoms, do not stop taking Xanax unless you first talk with your doctor. You should not stop your treatment suddenly. When you and your doctor agree that you should stop taking Xanax, they’ll reduce your dose slowly over time. This can help prevent withdrawal symptoms.
If you have withdrawal symptoms after your doctor has reduced your dose or had you stop treatment with Xanax, talk with them. Your doctor may increase your dosage again and then reduce it more slowly. However, if you have serious withdrawal symptoms, contact your doctor right away. If your symptoms feel life threatening, call 911 or your local emergency number immediately.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Whether Xanax is safe to take while pregnant may depend on how far along the pregnancy is. Clinical trials did not find an increased risk of congenital anomalies or pregnancy loss when Xanax was taken during early pregnancy. (Congenital anomalies are commonly known as birth defects.)
However, if Xanax is taken in the third trimester (weeks 29 to 40) or during labor or delivery, it may cause harm. The newborn may experience problems such as:
- excessive sleepiness
- floppiness
- breathing problems
- feeding problems
- withdrawal symptoms,* such as irritability, restlessness, tremor, and prolonged crying
If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of taking Xanax.
* Withdrawal symptoms are side effects that occur when you stop having a drug your body has become dependent on. With dependence, your body becomes reliant on a drug to function as usual. For more information, see the “Xanax dependence and withdrawal” section above.
Pregnancy exposure registry
If your doctor prescribes Xanax during pregnancy, they may want you to sign up with the pregnancy exposure registry for the drug. This registry monitors the health of people who are pregnant and take Xanax, and their babies. It aims to help healthcare professionals find out how safe psychiatric medications such as Xanax are during pregnancy. To find out more, talk with your doctor.
Whether Xanax is safe to take during pregnancy may depend on how far along the pregnancy is. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Xanax.
For more information about taking Xanax during pregnancy, see the “Xanax and pregnancy” section above.
Breastfeeding is not recommended while taking Xanax.
Xanax passes into breast milk and may have harmful effects in a child who is breastfed. These effects may include excessive sleepiness and withdrawal symptoms.* The withdrawal symptoms can include irritability, sleeping problems, and vomiting. Diarrhea, muscle twitching, and tremor are other possible symptoms.
If you’re breastfeeding or planning to breastfeed, talk with your doctor about other treatment options. If you’re prescribed Xanax, talk with your doctor about how to feed your child while taking the medication.
* Withdrawal symptoms are side effects that occur when you stop having a drug your body has become dependent on. With dependence, your body becomes reliant on a drug to function as usual. For more information, see the “Xanax dependence and withdrawal” section above.
You should take Xanax according to the instructions your doctor gives you.
Xanax comes as an oral tablet.
When to take
You’ll usually take Xanax three times per day. For example, you may take it in the morning, after lunch, and in the evening. If you have anxiety that prevents you from falling asleep at night, your doctor may recommend taking your last dose of Xanax before going to bed.
Try to stick to the same times each day. Taking the medication around the same times of day helps keep a steady level of the drug in your body. This helps Xanax work effectively.
To help make sure that you do not miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
Accessible labels and containers
If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy does not have these options, your doctor or pharmacist may be able to direct you to one that does.
If you have trouble opening medication bottles, ask your pharmacist if they can put Xanax in an easy-open container. They also may be able to recommend tools that can make it simpler to open lids.
Taking Xanax with food
You can take Xanax on an empty stomach or after eating. And you can take the medication with or without food.
Can Xanax be crushed, split, or chewed?
Xanax tablets are scored and can be split if your doctor or pharmacist advises this. However, Xanax is not meant to be crushed or chewed. The manufacturer does not provide information on taking Xanax this way. If you have trouble swallowing Xanax, talk with your doctor or pharmacist.
As with all medications, the cost of Xanax can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Before approving coverage for Xanax, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.
If you’re not sure whether you’ll need to get prior authorization for Xanax, contact your insurance company.
Financial assistance and cost savings
If you need financial support to pay for Xanax, help is available.
A savings card is available for Xanax. For more information and to find out if you’re eligible for support, call 855-854-4535 or visit the program website.
You can also visit this page to access Optum Perks coupons and get price estimates for Xanax when you use the coupons. These coupons can provide significant savings on your prescription costs.
Note: Optum Perks coupons cannot be used with any insurance copays or benefits.
To learn more about saving money on prescriptions, check out this article.
Generic version
Xanax is available in a generic form called alprazolam. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of alprazolam compares to the cost of Xanax, see this article.
If your doctor has prescribed Xanax and you’re interested in taking alprazolam instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.
When you get Xanax from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.
The expiration date helps guarantee that the medication is effective during this time. The
Storage
How long a medication remains good can depend on many factors, including how and where you store the medication.
You should store Xanax tablets at room temperature in a tightly sealed container. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.
Disposal
If you no longer need to take Xanax and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.
This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.
Xanax is prescribed for generalized anxiety disorder and panic disorder.
Xanax is a type of drug called a benzodiazepine. It eases anxiety by boosting the effect of GABA, a type of neurotransmitter in your brain. GABA is short for gamma-aminobutyric acid.
Neurotransmitters are chemicals that help pass messages between nerve cells in your brain. GABA helps pass nerve messages that have a calming effect on your brain.
By boosting the effect of GABA, Xanax helps reduce nervous tension and feelings of anxiety. The drug makes you feel more relaxed.
How long does it take to work?
Xanax starts working about 30 minutes to 1 hour after taking a dose.
This drug comes with several precautions. These are considered drug-condition interactions.
FDA warnings
This drug has
Risk of misuse and addiction. Xanax has a risk of misuse and addiction. With misuse, a drug is taken for a purpose or in a way that a doctor has not prescribed. Misuse can lead to addiction, which is when you’re unable to stop taking a drug, even though it may be causing harm. To learn more, see the “Xanax misuse and addiction” section above.
Risk of dependence and withdrawal. Xanax has a risk of dependence and withdrawal. With dependence, your body becomes reliant on a drug to function as usual. Dependence can lead to withdrawal symptoms if you suddenly stop taking the drug. For more information, see the “Xanax dependence and withdrawal” section above.
Risk of severe harm or death if taken with opioids. Taking Xanax with an opioid may cause severe side effects. These can include excessive sleepiness, breathing problems, coma, and in rare cases, death. Due to these risks, doctors will typically not prescribe Xanax with an opioid unless no other treatment options are suitable.
Opioids are powerful drugs that are also known as opiates or narcotics. They include strong prescription pain relievers, such as hydrocodone (Hysingla ER) and certain illegal drugs. For more examples, see the “Xanax interactions” section above.
If your doctor does prescribe Xanax with an opioid, they’ll prescribe the lowest possible dosage of both medications for the shortest possible time.* Be sure to tell people you live with, your caregiver, and people close to you that you’re taking these medications together. You or another person should call 911 right away if:
- you become very sleepy or unresponsive
- your breathing becomes slow and shallow
- your breathing stops altogether
Also, you should not drive or perform other potentially dangerous activities, such as operating machines, until you know how the drug combination affects you.
For more information about this boxed warning, talk with your doctor.
* Your doctor may advise you to have naloxone (Narcan) nasal spray on hand to help treat a known or suspected opioid overdose. They can prescribe the drug, or you can request it at a pharmacy. To learn more, talk with your doctor or pharmacist.
Other precautions
Before taking Xanax, talk with your doctor about your health history. Xanax may not be right for you if you have certain medical conditions or other factors affecting your health. These include:
- Allergic reaction. If you’ve ever had an allergic reaction to Xanax or any of its ingredients, your doctor will likely not prescribe Xanax. Also, if you’ve ever had an allergic reaction to other benzodiazepine drugs, such as diazepam (Valium) or lorazepam (Ativan), your doctor will likely not prescribe Xanax. (Xanax is a benzodiazepine drug.) Taking Xanax could cause another allergic reaction. You can ask your doctor what other medications may be better options for you.
- Older age. If you’re age 65 years or older, you may have an increased risk of side effects with Xanax. These include sleepiness, dizziness, and problems with coordination that may raise your risk of falls. Due to these risks, your doctor will likely prescribe a dosage of Xanax that’s lower than usual.
- Liver problems. Your liver breaks down Xanax in your body. If you have a liver problem, such as alcohol-related liver disease, Xanax may build up in your body. This can increase your risk of side effects. Due to this risk, your doctorwill likely prescribe a dosage of Xanax that’s lower than usual.
- Kidney problems. Your kidneys help remove Xanax from your body. If you have a kidney problem, such as kidney failure, you may have an increased risk of side effects with Xanax. Your doctor may prescribe a Xanax dosage that’s lower than usual.
- Breathing problems. Xanax can cause breathing problems, such as slowed breathing. If you have a lung or breathing problem, such as chronic obstructive pulmonary disease (COPD) or sleep apnea, Xanax could make your condition worse. You can talk with your doctor about whether Xanax is right for you.
- Depression or bipolar disorder. Xanax may worsen depression or cause episodes of mania in people with depression. If you have a history of depression or bipolar disorder, talk with your doctor about whether Xanax is right for you.
- Pregnancy. Whether Xanax is safe to take during pregnancy may depend on how far along the pregnancy is. For more information, see the “Xanax and pregnancy” section above.
- Breastfeeding. Breastfeeding is not recommended while taking Xanax. For more information, see the “Xanax and breastfeeding” section above.
Note: For more information about the potential negative effects of Xanax, see the “Xanax side effects” section above.
Using more than the recommended dosage of Xanax can lead to serious side effects and, in rare cases, death. Do not take more Xanax than your doctor recommends. (For information on the recommended dosages of Xanax, see the “Xanax dosage” section above.)
Overdose symptoms
Symptoms of an overdose can include:
- sleepiness
- confusion
- problems with coordination and balance
- reduced reflexes
- coma
What to do in case of overdose
If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
