alprazolam
Brand names: Xanax
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
100%
Generic Available
Yes (12 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
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.
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.
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.
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.
Storage
Store alprazolam at room temperature, away from moisture and heat.
Side Effects (from patient reports)
Based on 104,940 FDA adverse event reports.
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
Death-Related Reports
32,899
Hospitalization Reports
64,280
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DRUG INEFFECTIVE | 13,399 |
| 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 |
Reactions in Death Reports
Reactions in Hospitalization Reports
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.
( 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.
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.
Common Questions
Can I drink alcohol while taking alprazolam?
Can I drive while taking alprazolam?
What should I do if I feel like alprazolam is not working anymore?
Can I take alprazolam with other medications?
How long does alprazolam stay in my system?
Is it safe to stop alprazolam suddenly?
What are the symptoms of alprazolam withdrawal?
Can alprazolam cause depression?
Is alprazolam addictive?
What should I do if I overdose on alprazolam?
What are the common side effects of alprazolam?
Does alprazolam interact with other medications?
What drug class is alprazolam?
Is there a generic version of alprazolam?
Is alprazolam safe during pregnancy?
Has alprazolam been recalled?
Active Recalls
CGMP Deviations: Repackaging firm recalling due to potential product cross contamination concerns at the manufacturer.
Direct Rx
CGMP Deviations: Repackaging firm recalling due to potential product cross contamination concerns at the manufacturer.
Direct Rx
Related Medications in Benzodiazepine
Other drugs grouped near alprazolam — same-class peers and common alternatives.
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amitriptyline
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amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
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aripiprazole
Abilify
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asenapine
Saphris
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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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 104,940 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 100% 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 2 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
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages