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Prescription medication · Benzodiazepine

alprazolam

Also sold as Xanax. Alprazolam is used to treat generalized anxiety disorder (GAD) and panic disorder (PD) in adults.

Data updated 2026-05-15

200,719
FDA reportsHeavily reported
27
InteractionsSeveral interactions
99% less
Generic vs brandHuge savings
3
Recall records

What the data shows

alprazolam (Xanax) is a prescription Benzodiazepine, in the top 5% of tracked drugs by FAERS report volume (200,719 FDA reports), whose generic costs a fraction of the brand (about 99% less).

Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.

alprazolam (Xanax) is a prescription Benzodiazepine. Alprazolam is used to treat generalized anxiety disorder (GAD) and panic disorder (PD) in adults.

Alprazolam (Xanax) is a medication that can help you with anxiety and panic disorders. It belongs to a class of drugs called benzodiazepines, which work by slowing down activity in the brain.

Drug Pricing (NADAC)

Brand Price

$5.23/unit

Generic Price

$0.02/unit

Generic Savings

99%

Generic Available

Yes (12 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

View Alternatives → Compare with Another Drug → Full Side Effects Report →

What it does

Alprazolam is used to treat generalized anxiety disorder (GAD) and panic disorder (PD) in adults.

Common side effects

Drowsiness, Light-headedness, Dry mouth

Key warnings

Alprazolam can be habit-forming, leading to abuse, misuse, and addiction, which can result in overdose or death.

The sections below are summarized in plain English from alprazolam's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.

How It Works

Alprazolam works by affecting certain chemicals in your brain called neurotransmitters. It enhances the effects of a neurotransmitter called GABA, which helps to calm your nerves. This can reduce feelings of anxiety and panic.

How to Take It

For anxiety, the usual starting dose is 0.25 mg to 0.5 mg three times a day. Your doctor may increase the dose every 3 to 4 days, up to a maximum of 4 mg per day. For panic disorder, the starting dose is 0.5 mg three times a day, and your doctor may increase it every 3 to 4 days by no more than 1 mg per day. Always use the lowest dose that works for you, and talk to your doctor about how long you need to take it.

This is a plain-language summary of alprazolam's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.

Pregnancy & Breastfeeding

Taking alprazolam late in pregnancy can cause sedation or withdrawal symptoms in the newborn. Breastfeeding is not recommended while taking alprazolam because it can cause sedation and feeding problems in the baby.

This is a plain-language summary of alprazolam's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

This is a plain-language summary of alprazolam's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.

Storage

Store alprazolam at room temperature, away from moisture and heat.

Side Effects (from patient reports)

Based on 200,719 FDA adverse event reports.

Most-reported reactions

Adverse reactions in FAERS for alprazolam, by number of reports

reports

What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.

Source FDA Adverse Event Reporting System (FAERS) As of 2025

Reports over time

Adverse-event reports filed for alprazolam each year to the FDA Adverse Event Reporting System (FAERS).

-5,00005,00010,00015,00020,000 2001200520092013201720212025 8,200

Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.

Where alprazolam sits

alprazolam has more FDA adverse-event reports than 95% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.

fewest reports most reports

Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is alprazolam; the line is the median (50th percentile).

FDA Adverse Event Report Analysis

Detailed analysis of 200,719 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2001–2025.

Total Reports

200,719

Reports Mentioning Death

32,899

16.4% of reports — not proof of cause

Hospitalization Reports

64,280

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 128,117 (67%)
Male 61,107 (32%)

Age Distribution

0–17 2,655
18–44 37,986
45–64 54,477
65–74 23,665
75+ 18,812

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
2 NAUSEA 12,856
3 FATIGUE 11,933
4 DRUG ABUSE 10,943
5 ANXIETY 10,174
6 HEADACHE 9,926
7 PAIN 9,818
8 TOXICITY TO VARIOUS AGENTS 8,863
9 DIARRHOEA 8,787
10 DYSPNOEA 8,255
11 DIZZINESS 7,861
12 COMPLETED SUICIDE 7,524
13 DEPRESSION 7,225
14 INSOMNIA 7,179
15 VOMITING 7,134
17 FALL 6,923

Reactions in Death Reports

COMPLETED SUICIDE 7,504
DEATH 6,876
DRUG ABUSE 5,945
TOXICITY TO VARIOUS AGENTS 5,601
CARDIAC ARREST 3,108
CARDIO-RESPIRATORY ARREST 2,655
RESPIRATORY ARREST 2,621
OVERDOSE 1,893
POISONING 1,311
DRUG DEPENDENCE 768

Reactions in Hospitalization Reports

NAUSEA 4,427
FALL 4,053
DYSPNOEA 4,040
PAIN 3,718
ANXIETY 3,527
VOMITING 3,476
PNEUMONIA 3,450
FATIGUE 3,362
DIARRHOEA 3,247
TOXICITY TO VARIOUS AGENTS 3,142

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Alprazolam can be habit-forming, leading to abuse, misuse, and addiction, which can result in overdose or death. Taking alprazolam with opioid pain medicines can cause severe sleepiness, breathing problems, coma, and death. Suddenly stopping alprazolam can cause life-threatening withdrawal symptoms. Talk to your doctor about how to safely stop taking it.

Known Drug Interactions

Examples Ketoconazole, itraconazole, clarithromycin Moderate or Weak Inhibitors of CYP3A Clinical implication Concomitant use of alprazolam with CYP3A inhibitors may increase the concentrations of alprazolam, resulting in increased risk of adverse reactions of alprazolam [see Clinical Pharmacology (12.3) ].

Mechanism: Ketoconazole stops the body from breaking down alprazolam normally, which can increase the risk of side effects.

What to do: Your doctor may need to adjust your dose or monitor you more closely for signs of extra sleepiness.

Examples Ketoconazole, itraconazole, clarithromycin Moderate or Weak Inhibitors of CYP3A Clinical implication Concomitant use of alprazolam with CYP3A inhibitors may increase the concentrations of alprazolam, resulting in increased risk of adverse reactions of alprazolam [see Clinical Pharmacology (12.3) ].

Mechanism: Clarithromycin interferes with the liver's ability to clear alprazolam, which may make the alprazolam stay in your system longer.

What to do: Watch for increased side effects and check with your doctor to see if your alprazolam dose needs to be changed.

Examples Ketoconazole, itraconazole, clarithromycin Moderate or Weak Inhibitors of CYP3A Clinical implication Concomitant use of alprazolam with CYP3A inhibitors may increase the concentrations of alprazolam, resulting in increased risk of adverse reactions of alprazolam [see Clinical Pharmacology (12.3) ].

Mechanism: Itraconazole slows the breakdown of alprazolam in the body, which can increase the amount of medicine in your blood.

What to do: Use these medications together with caution and notify your doctor if you feel overly tired or dizzy.

moderate digoxin

( 7.1 ) Use with Digoxin: Increase the risk of digoxin toxicity. Digoxin Clinical implication Increased digoxin concentrations have been reported when alprazolam was given, especially in geriatric patients (>65 years of age). Prevention or management In patients on digoxin therapy, measure serum digoxin concentrations before initiating alprazolam.

Mechanism: Alprazolam can cause digoxin levels to build up in the body, which can lead to dangerous side effects. This happens more often in patients over the age of 65.

What to do: Your doctor should check your digoxin blood levels before you start taking alprazolam.

moderate aprepitant

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology ( 12.3 )]. Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology ( 12.3 )].

Mechanism: Aprepitant slows down how fast your body processes alprazolam, which causes the drug to build up in your blood. This can make you feel much more sleepy or dizzy than usual.

What to do: Your doctor may need to lower your dose of alprazolam. Watch closely for increased side effects like extreme drowsiness.

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This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.

Common Questions

Can I drink alcohol while taking alprazolam?
No, you should avoid alcohol while taking alprazolam. Alcohol can increase the sedative effects of alprazolam and lead to dangerous side effects.
Can I drive while taking alprazolam?
Alprazolam can cause drowsiness and dizziness, so you should not drive or operate heavy machinery until you know how it affects you.
What should I do if I feel like alprazolam is not working anymore?
Talk to your doctor. Do not increase the dose on your own.
Can I take alprazolam with other medications?
Talk to your doctor or pharmacist before taking alprazolam with other medications, as it can interact with other drugs.
How long does alprazolam stay in my system?
Alprazolam stays in your system for a few days, but this can vary depending on the person.
Is it safe to stop alprazolam suddenly?
No, you should not stop alprazolam suddenly. Talk to your doctor about how to gradually reduce the dose to avoid withdrawal symptoms.
What are the symptoms of alprazolam withdrawal?
Withdrawal symptoms can include anxiety, insomnia, seizures, and tremors.
Can alprazolam cause depression?
Alprazolam can sometimes worsen depression. Talk to your doctor if you have symptoms of depression.
Is alprazolam addictive?
Yes, alprazolam can be addictive. It should be used with caution and only as prescribed by your doctor.
What should I do if I overdose on alprazolam?
Seek immediate medical attention. Call 911 or go to the nearest emergency room.
What are the common side effects of alprazolam?
The most commonly reported side effects of alprazolam include Drowsiness, Light-headedness, Dry mouth. Based on 200,719 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does alprazolam interact with other medications?
Yes, alprazolam has 27 known drug interactions. Notable interactions include ketoconazole, clarithromycin, itraconazole. Always inform your doctor about all medications you are taking.
What drug class is alprazolam?
alprazolam belongs to the Benzodiazepine drug class. It requires a prescription (Rx). Alprazolam is used to treat generalized anxiety disorder (GAD) and panic disorder (PD) in adults.
Is there a generic version of alprazolam?
Yes, generic alprazolam is available from 12 manufacturers. The generic costs $0.02 per unit compared to $5.23 for the brand version, saving approximately 99%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is alprazolam safe during pregnancy?
Taking alprazolam late in pregnancy can cause sedation or withdrawal symptoms in the newborn. Breastfeeding is not recommended while taking alprazolam because it can cause sedation and feeding problems in the baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has alprazolam been recalled?
There are 3 recalls associated with alprazolam products. Failed Dissolution Specifications. Check the recalls section below for full details and affected products.

Active Recalls

Class II March 17, 2026

Failed Dissolution Specifications

Viatris, Inc.

Class II March 22, 2023

CGMP Deviations: Repackaging firm recalling due to potential product cross contamination concerns at the manufacturer.

Direct Rx

Class II March 22, 2023

CGMP Deviations: Repackaging firm recalling due to potential product cross contamination concerns at the manufacturer.

Direct Rx

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What the FDA Data Shows for alprazolam

The FDA label for alprazolam (sold under brand names such as Xanax) classifies it as a prescription-only medication in the Benzodiazepine class. Alprazolam is used to treat generalized anxiety disorder (GAD) and panic disorder (PD) in adults. Official labeling lists 3 commonly reported side effects, including Drowsiness, Light-headedness, Dry mouth.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 200,719 voluntary reports. The database also lists 27 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.02 versus $5.23 for the brand - a 99% generic savings.

Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 3 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: January 3, 2025

Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.

All federal data sources used on this page