Alprazolam (Xanax® or Xanax® XR and generic) is a benzodiazepine that is used as an anxiolytic. Here is basic information about this medication. Other articles on this website with more advanced information and tips related to this medication are linked to under Related Pages below.
Alprazolam (Xanax®)
FDA-approved indications
1. Anxiety Disorders
2. Panic Disorder, with or without agoraphobia
Dosage
Anxiety disorders and transient symptoms of anxiety
Initial: 0.25–0.5 mg three times daily
Dose Titration: Increments may occur at intervals of 3-4 days
Maximum: 4 mg/day (in divided doses)
Panic Disorder
Initial: 0.5 mg three times daily
Dose Titration: Increments of no more than 1 mg/day may occur at intervals of 3-4 days; slower titration to dose levels greater than 4 mg/day
Dose Range: 1–10 mg/day
Discontinuation/Dose reduction
Daily dosage be decreased by no more than 0.5 mg every three days
Special Populations
In elderly patients, in patients with advanced liver disease, and in patients with debilitating disease, the usual starting dose is 0.25 mg, given two or three times daily.
Dosage forms and strengths
Tablets (Xanax® or generic):
0.25 mg (scored)
0.5 mg (scored)
1 mg (scored)
2 mg (multi-scored): can be used as the complete 2 mg tablet, two 1 mg segments, or four 0.5 mg segments.
Orally disintegrating tablets (generic): 0.25 mg, 0.5 mg, 1 mg, and 2 mg
Oral concentrate: 1 mg/mL
Potential side effects
Please see THIS PAGE for a handout listing both the common and less common side effects of this medication along with the percentages of patients who report them:
Important! Please refer to the full Prescribing Information (see link below) before prescribing this medication.
Alprazolam, extended-release (Xanax® XR)
FDA-approved indications
Panic Disorder, with or without agoraphobia
Dosage
Initial: 0.5–1 mg once daily in the morning
Dose Titration: Dose increments of no more than 1 mg/day at intervals of 3 to 4 days
Usual: 3–6 mg once daily (Range: 1–10 mg/day)
Discontinuation/Dose reduction
Daily dosage be decreased by no more than 0.5 mg every three days
Special Populations
In elderly patients, in patients with advanced liver disease or in patients with debilitating disease, the usual starting dose is 0.5 mg, given once daily. Dose may be titrated upward if needed and tolerated.
Switch from Xanax® (immediate-release) Tablets to Xanax® XR (extended-release) Tablets
Patients who are currently being treated with divided doses of alprazolam (immediate-release) tablets, for example 3 to 4 times a day, may be switched to alprazolam XR Tablets at the same total daily dose taken once daily. If the therapeutic response after switching is inadequate, the dosage may be titrated as outlined above.
Dosage forms and strengths
Tablets (Xanax® XR and generic): 0.5 mg, 1 mg, 2 mg, 3 mg
Important! Please refer to the full Prescribing Information (see link below) before prescribing this medication.
Related Pages
How to convert from alprazolam immediate-release to extended-release
Potential advantages and disadvantages of alprazolam extended-release (Xanax XR®)
Important facts about benzodiazepines
Three important pieces of information about benzodiazepines
Tips on using clonazepam ODT (wafers)
Should we consider a benzodiazepine for persons with major depressive disorder?
Which benzodiazepines for alcohol withdrawal syndrome (AWS)?
Benzodiazepine regimens for preventing or treating alcohol withdrawal
Benzodiazepines in the elderly and in liver disease
Chlordiazepoxide (Librium®): Basic Information
Clonazepam (Klonopin®): Basic Information
Diazepam (Valium®): Basic Information
Lorazepam (Ativan®): Basic Information
Oxazepam (Serax®): Basic Information
References
Alprazolam Prescribing Information
Alprazolam XR Prescribing Information
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