Two medicines, side by side
Alprazolam vs fluoxetine
Alprazolam and fluoxetine are both labeled for anxiety. Drugs@FDA records approvals of alprazolam since 1981 and of fluoxetine since 1987. Pharmacies paid $0.0236 per alprazolam 0.25 mg tablet and $0.0519 per fluoxetine HCl 40 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, alprazolam is a benzodiazepine and fluoxetine a serotonin reuptake inhibitor.
Check it at the source: the alprazolam FDA label on DailyMed (effective January 18, 2023); the fluoxetine FDA label on DailyMed (effective January 8, 2026).
Highlights of the alprazolam record
Alprazolam (Xanax) · label of January 18, 2023
RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required.
Used for
From the label: indicationsXANAX is indicated for the: • acute treatment of generalized anxiety disorder (GAD) in adults. • treatment of panic disorder (PD), with or without agoraphobia in adults. XANAX is a benzodiazepine indicated for the: • Acute treatment of generalized anxiety disorder in adults. ( 1 ) • Treatment of panic disorder with or without agoraphobia in adults.
On the market
- Earliest approval on file
- October 16, 1981
- Generic labelers
- 30 labelers
- Pharmacy cost
- $0.0236 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 23
Highlights of the fluoxetine record
Fluoxetine (Prozac) · label of January 8, 2026
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older [see Warnings and Precautions ( 5.1 )].
Used for
From the label: indicationsPROZAC ® is indicated for the treatment of: Acute and maintenance treatment of Major Depressive Disorder [see Clinical Studies ( 14.1 )]. Acute and maintenance treatment of obsessions and compulsions in patients with Obsessive Compulsive Disorder (OCD) [see Clinical Studies ( 14.2 )]. […]
On the market
- Earliest approval on file
- December 29, 1987
- Generic labelers
- 58 labelers
- Pharmacy cost
- $0.0519 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 9
Source: FDA drug labels via openFDA (Alprazolam label of January 18, 2023, Fluoxetine label of January 8, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do alprazolam and fluoxetine differ on the record?
In FDA's classes, alprazolam is a benzodiazepine and fluoxetine a serotonin reuptake inhibitor.
How each works, in its label's words: Alprazolam, “Alprazolam is a 1,4 benzodiazepine.”; Fluoxetine, “Although the exact mechanism of PROZAC is unknown, it is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin.”
Half-life, in each label's words: Alprazolam, “Elimination The mean plasma elimination half-life (T 1/2 ) of alprazolam is approximately 11.2 hours (range: 6.3 to …”; Fluoxetine, “Its mean terminal half-life after a single dose was 8.6 days and after multiple dosing was 9.3 days.”
Both labels carry a boxed warning; the records quote them.
Generics: alprazolam since 1993; fluoxetine since 2001 (Drugs@FDA).
DEA schedule: alprazolam CIV; fluoxetine none.
| Alprazolam | Fluoxetine | |
|---|---|---|
| Labeled for | Anxiety | Depression, Anxiety, Bipolar disorder |
| Pharmacologic class | Benzodiazepine | Serotonin Reuptake Inhibitor |
| How it works (label) | Alprazolam is a 1,4 benzodiazepine. | Although the exact mechanism of PROZAC is unknown, it is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin. |
| Half-life (label) | Elimination The mean plasma elimination half-life (T 1/2 ) of alprazolam is approximately 11.2 hours (range: 6.3 to 26.9 hours) in healthy adults. | Its mean terminal half-life after a single dose was 8.6 days and after multiple dosing was 9.3 days. |
| Earliest approval on file (Drugs@FDA) | October 16, 1981 | December 29, 1987 |
| First generic approved | October 19, 1993 | August 2, 2001 |
| Generic labelers (NDC) | 30 labelers | 58 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0236 per tablet (Alprazolam 0.25 mg tablet) | $0.0519 per capsule (Fluoxetine HCl 40 mg capsule) |
| 12-month price change | -1% | -20% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 23 | 9 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 204,916 | 131,827 |
| DEA schedule | CIV | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Fluoxetine label, drug interactionsDiazepam – increased t½, alprazolam - further psychomotor performance decrement due to increased levels ( 7.7 ) Antipsychotics:
Source: FDA drug labels via openFDA
What do the labels say about using others of their kind?
Alprazolam label, drug interactionsCNS Depressants Clinical implication The benzodiazepines, including alprazolam, produce additive CNS depressant effects when coadministered with other CNS depressants.
Fluoxetine label, warnings and precautionsSerotonin syndrome has been reported with SSRIs and SNRIs, including PROZAC, both when taken alone, but especially when co-administered with other serotonergic agents.
Source: FDA drug labels via openFDA
What next?
- Alternatives to alprazolam
- every medicine labeled for the same conditions