Alprazolam

What side effects are possible with this medication?

A side effect is an unwanted response to a medication when it is taken in normal doses. It can be mild or severe, temporary or permanent, but does not occur in everyone. The following side effects have been reported by at least 1% of people taking this medication. If you develop any of these side effects (or any other side effects not listed here) or they change in intensity, speak to your doctor or pharmacist for advice on managing them and on the risks and benefits of the medication.

anxiety balance problems, loss of muscle coordination changes in appetite changes in body weight changes in sexual desire or ability constipation decreased sensitivity to touch depression disorientation or confusion drowsiness, fatigue, or unusual tiredness or weakness

dry mouth hot flashes intense itching muscle or joint pain nausea or vomiting painful menstruation (cramps) "pins-and-needles" feeling (burning, prickling, tingling) on the skin problems with memory or paying attention runny nose slurred speech sore throat

Click here to learn about serious side effects that can potentially occur with any medication. These examples are provided for information purposes only and are not meant to be exhaustive. Always consult your doctor for sound medical advice specific to your particular medication and treatment.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online or by phone at 1-800-332-1088.

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) can occur with benzodiazepines such as alprazolam extended release. Severe withdrawal symptoms may be experienced if the dose is significantly reduced or the medication is suddenly stopped. 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.

Drowsiness/reduced alertness: Because alprazolam extended release causes drowsiness and sedation, do not engage in activities requiring mental alertness, judgment, and physical coordination, such as driving or operating machinery, while taking it. This is particularly true when first taking the medication and until you have established that alprazolam extended release does not affect you this way. Consuming alcohol can increase the drowsiness effects and should be avoided.

Kidney, liver, or lung disease: People with kidney, liver, or lung disease may be at increased risk of experiencing side effects while taking alprazolam extended release. If you have kidney, liver, or lung disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition or medications may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Mania: Episodes of mania (a mental condition causing overexcitement, hyperactivity, excessively upbeat moods, and disorganized behavior) and hypomania (a milder form of mania) have been reported in association with the use of alprazolam extended release in people with depression.

Suicidal behavior: People taking this medication may feel emotional or they may want to hurt themselves. If you are taking this medication, you should be closely monitored by your doctor for emotional and behavior changes.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. If you are a breast-feeding mother and are taking alprazolam extended-release, talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children under the age of 18 years.

Seniors: Seniors may be more at risk of experiencing side effects such as drowsiness and coordination problems. For this reason, they should use extra caution when getting up during the night.

What other drugs could interact with this medication?

There may be an interaction between alprazolam extended release and any of the following:

alcohol antifungals (e.g., ketoconazole, itraconazole, fluconazole) antihistamines (e.g., diphenhydramine) antivirals used for HIV (e.g., indinavir, ritonavir, efavirenz) barbiturates (e.g., phenobarbital) birth control pills carbamazepine cimetidine

desipramine diltiazem fluvoxamine fluoxetine imipramine isoniazid macrolide antibiotics (e.g., erythromycin, clarithromycin) narcotics (e.g., codeine) nefazodone propoxyphene rifampin sertraline

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.