Two medicines, side by side
Alprazolam vs sertraline
Alprazolam and sertraline are both labeled for anxiety. Drugs@FDA records approvals of alprazolam since 1981 and of sertraline since 1991. Pharmacies paid $0.0236 per alprazolam 0.25 mg tablet and $0.0507 per sertraline HCl 100 mg tablet (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 sertraline a serotonin reuptake inhibitor.
Check it at the source: the alprazolam FDA label on DailyMed (effective January 18, 2023); the sertraline FDA label on DailyMed (effective August 8, 2023).
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 sertraline record
Sertraline (Zoloft) · label of August 8, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [See Warnings and Precautions (5.1) ]. WARNING: SUICIDAL THOUGHTS AND BEHAVIORS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsZOLOFT is indicated for the treatment of the following [See Clinical Studies (14) ]: • Major depressive disorder (MDD) • Obsessive-compulsive disorder (OCD) • Panic disorder (PD) • Posttraumatic stress disorder (PTSD) • Social anxiety disorder (SAD) • Premenstrual dysphoric disorder (PMDD) ZOLOFT is a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of ( 1 ): • Major depressive disorder […]
On the market
- Earliest approval on file
- December 30, 1991
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0507 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Source: FDA drug labels via openFDA (Alprazolam label of January 18, 2023, Sertraline label of August 8, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do alprazolam and sertraline differ on the record?
In FDA's classes, alprazolam is a benzodiazepine and sertraline a serotonin reuptake inhibitor.
How each works, in its label's words: Alprazolam, “Alprazolam is a 1,4 benzodiazepine.”; Sertraline, “Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).”
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 …”; Sertraline, “The average terminal elimination half-life of plasma sertraline is about 26 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: alprazolam since 1993; sertraline since 2006 (Drugs@FDA).
DEA schedule: alprazolam CIV; sertraline none.
| Alprazolam | Sertraline | |
|---|---|---|
| Labeled for | Anxiety | Depression, Anxiety |
| Pharmacologic class | Benzodiazepine | Serotonin Reuptake Inhibitor |
| How it works (label) | Alprazolam is a 1,4 benzodiazepine. | Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT). |
| 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. | The average terminal elimination half-life of plasma sertraline is about 26 hours. |
| Earliest approval on file (Drugs@FDA) | October 16, 1981 | December 30, 1991 |
| First generic approved | October 19, 1993 | June 30, 2006 |
| Generic labelers (NDC) | 30 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0236 per tablet (Alprazolam 0.25 mg tablet) | $0.0507 per tablet (Sertraline HCl 100 mg tablet) |
| 12-month price change | -1% | -3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 23 | 3 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 204,916 | 218,311 |
| 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)
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.
Sertraline label, warnings and precautionsIncreased risk when co-administered with other serotonergic agents, but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to alprazolam
- every medicine labeled for the same conditions