In this drug factsheet:
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal or stomach cramps or pain
- blurred vision or other changes in vision
- changes in sexual desire or ability
- clumsiness or unsteadiness
- dizziness or lightheadedness
- dry mouth
- false sense
- increased thirst
- increased watering of mouth
- muscle spasm
- nausea or vomiting
- problems with urination
- slurred speech
- trembling or shaking
- unusual tiredness or weakness
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- abnormal thinking (e.g., disorientation, delusions, or loss of sense of reality)
- behaviour changes (e.g., aggressive behaviour, bizarre behaviour, decreased inhibition, or outbursts of anger)
- fast, pounding, or irregular heartbeat
- loss of memory
- low blood pressure
- mental depression
- muscle weakness
- skin rash or itching
- sore throat, fever, and chills
- trouble sleeping
- ulcers or sores in mouth or throat
- uncontrolled movements of body, including the eyes
- unusual bleeding or bruising
- unusual excitement, nervousness, or irritability
- unusual tiredness or weakness (severe)
- yellow eyes or skin
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors
may affect how you should use this medication.
Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as alprazolam. Severe withdrawal symptoms may be experienced if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually, under medical supervision, can help prevent or decrease these withdrawal symptoms.
Because the treatment of panic disorder often requires the use of average daily doses of alprazolam above 3 mg, the risk of dependence among people with panic disorder may be higher than that among those treated for less severe anxiety.
Drowsiness/reduced alertness: Do not engage in activities requiring mental alertness,
judgment, and physical coordination, such as driving or operating machinery, until you have established that alprazolam does not affect you this way. Alcohol can increase the drowsiness effects and should be avoided.
Kidney or liver disease: People with kidney disease or liver disease should be closely monitored by their doctor while taking alprazolam as they may be at increased risk of experiencing side effects.
Pregnancy: The safety of alprazolam during pregnancy has not been established. It is not recommended for use by pregnant women.
Breast-feeding: Alprazolam may pass into breast milk. If possible, nursing mothers should avoid using this medication.
Children and adolescents: The safety and efficacy of alprazolam for children and adolescents under 18 years of age have not been established.
Seniors: Seniors may be at increased risk of experiencing side effects such as sedation and impaired coordination. They should, for example, use extra caution when getting up during the night.
What other drugs could interact with this medication?
There may be an interaction between alprazolam and any of the following:
- antifungals (e.g., ketoconazole, itraconazole, fluconazole)
- antihistamines (e.g., diphenhydramine)
- anti-HIV medications (e.g., indinavir, ritonavir, efavirenz)
- barbiturates (e.g., phenobarbital, cimetidine)
- birth control pills
- macrolide antibiotics (e.g., erythromycin, clarithromycin)
- narcotics (e.g., codeine)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.