Alprazolam - Use | Dose | Side Effects

This article was medically reviewed by M.Pharm, Marko Tanaskovic on August 12, 2018. To read more about an author, click here.

Alprazolam is a drug that belongs to the group of benzodiazepines. Alprazolam reduce anxiety and fear and cause sedation (acts as a sedative). It is used for anxiety and fear treatment.


Alprazolam should not be used in the following conditions:

  • If you are allergic to Alprazolam or other benzodiazepines such as: diazepam (Bensedin), lorazepam, nitrazepam, bromazepam and others. If you are experiencing symptoms of an allergy (itching, swelling, redness), contact your doctor immediately.
  • If you have myasthenia gravis (severe muscle disorder). Alprazolam may worsen myasthenia gravis.
  • If you have liver disorders.
  • If you have trouble breathing.
  • If you have glaucoma (increased eye pressure).

It should be avoided in combination with alcoholic beverages, because alcohol can increase the effect of alprazolam and cause serious side effects!

It should not be used for longer periods of time (no longer than 2-3 months), because it can cause addiction!

Do not stop using this medication abruptly because it may lead to withdrawal symptoms: severe headache, insomnia, agitation, irritability, muscle pain and other symptoms. The dose of Alprazolam should be gradually reduced for 0.5 mg every 3-4 days. For example, if you are taking 2 mg of Alprazolam per day, then you will need to take 1.5 mg for 3-4 days, then 1 mg per day for 3-4 days and finally 0.5 mg for 3-4 days. Then you can completely stop taking Alprazolam.

In this way, you will avoid the withdrawal syndrome.

Use of Alprazolam during pregnancy and breastfeeding

Alprazolam should not be used during pregnancy and breastfeeding, unless it is necessary.

It can be used during pregnancy only if the benefit to the mother outweighs the risk to the child.

According to the FDA, it belongs to the group D (FDA: Group D), which means that this medication is harmful to the fetus.

Alprazolam passes into breast milk and may harm your baby. Avoid breastfeeding while using Alprazolam.

How to use

Usual dose of Alprazolam is 0.25-0.5 mg, three times a day. Alprazolam should be started at a low dose. The dose may be gradually increased until you reach desired effect. The maximum daily dose is 3 mg, in divided doses.

Take the tablet with a 8 fl. oz. of plain water. Do not crush the tablet, just swallow it whole.

Alprazolam is most commonly used in the evening in higher dosage than during the day (e.g. If you are taking 0.25 mg during the day, then the doctor will tell you to take 0.5 mg in the evening).

Use with other medicines (Interactions)

Alprazolam should not be used in combination with the following medications:

  • If you are taking other medicines to treat anxiety or depression such as: fluoxetine, paroxetine, fluvoxamine, sertraline, and others.
  • If you are taking hypnotics.
  • If you are taking narcotic (opiate) analgesics-pain medications, such as: morphine, codeine, oxycodone, tramadol, and others.
  • If you are taking medicines to treat fungal infections, such as ketoconazole, fluconazole, itraconazole and others.
  • If you are taking medicines for heart disorders treatment, such as nifedipine, nicardipine, amiodarone, and others.
  • If you are taking medicines for AIDS (HIV) treatment, such as: efavirenz, nelfinavir, saquinavir and others.
  • If you are taking cyclosporine - a drug used to treat autoimmune disorders
  • If you are taking medications to treat epilepsy, such as: carbamazepine, valproic acid, phenytoin, phenobarbital and others.
  • If you are taking antibiotics, such as: erythromycin, azithromycin, clarithromycin, and others.
  • If you are taking oral contraceptives to prevent unwanted pregnancy, such as: Yasmin.
  • If you are taking St. John's wort.

Tell your doctor about all medications and herbal medicines you are taking because Alprazolam may interact with many medicines.

Side effects

Alprazolam can cause the following side effects:

  • liver damage (which is manifested by the appearance of jaundice yellowing of the skin and eyes)
  • akathisia (a feeling of inner restlessness)
  • agitation
  • irritability
  • headaches
  • memory loss
  • hallucinations
  • anger
  • aggression
  • suicidal thoughts
  • lack of attention
  • impaired coordination
  • nausea
  • vomiting
  • diarrhea
  • abdominal pain
  • dizziness
  • dry mouth
  • impotence
  • blurred vision
  • fatigue
  • allergy and others

Tell your doctor if you are experiencing any side effect.

Information on this website are provided for educational purposes only and are not intended for medical advice, diagnosis or treatment.

If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.

We and our partners use technology such as cookies on our site to personalise content and ads, provide social media features, and analyse our traffic. Click below to consent to the use of this technology across the web. You can change your mind and change your consent choices at anytime by returning to this site.