If you have anxiety, your medical professional may recommend that you take a prescription drug called Xanax.

Xanax is used to treat the following conditions in adults:

We’ll explain more about GAD, panic disorder, and how Xanax helps treat them in the “What do you use Xanax for?” section below.

Xanax details

Xanax belongs to a group of drugs called benzodiazepines.

Xanax contains the active drug alprazolam, which is a controlled substance. The federal government regulates controlled substances because taking them may lead some people to misuse the drugs.

Xanax comes as tablets that you take by mouth. The medication is available in two forms: immediate-release (Xanax) and extended-release (Xanax XR). “Immediate-release” means the drug releases quickly into your body after you take it. “Extended-release” means the drug releases slowly into your body over time.

We cover only the immediate-release form of Xanax in this article. If you’d like to learn about Xanax XR, talk with your medical professional or pharmacist.

Xanax generic

Xanax is a brand-name drug. It’s also available as a generic drug called alprazolam.

Most medications may cause side effects that can be serious or mild. Xanax may also cause such side effects. To give you an idea of what might occur with Xanax, we’ve listed some of the medication’s more common side effects below. Keep in mind that we haven’t included all the potential side effects.

For more complete information on possible side effects of Xanax, you can talk with your medical professional or pharmacist. They may also be able to recommend tips on how to help prevent and ease side effects.

Note: Certain factors may affect a medication’s side effects. These factors can include the condition you’re using the drug to treat, other health conditions you may have, other drugs you may be taking, and your age.

Mild side effects

Some of the mild side effects that Xanax may cause are listed below. For information on other mild side effects of the drug, we suggest that you talk with your medical professional or pharmacist. It may also be helpful to refer to the medication guide for Xanax.

Mild side effects of Xanax that have been reported in studies include the following:

Mild side effects of many drugs tend to fade in a couple of days or a few weeks. But if you find that the side effects bother you, talk with your medical professional or pharmacist.

* For details on this side effect, see “Side effects: A closer look” below.

Serious side effects

Xanax may cause serious side effects, but this isn’t common. If you do develop serious side effects while taking Xanax, be sure to call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Serious side effects of Xanax that have been reported in studies include the following:

  • feeling sleepy, which could be dangerous if you drive
  • problems with concentration, learning, or memory
  • seizures (if you suddenly stop taking the drug)
  • weakness in the muscles you use to speak, which may cause slurred or slowed speech
  • low blood pressure*
  • allergic reaction*
  • boxed warnings:

* For details on this side effect, see “Side effects: A closer look” below.

Side effects: A closer look

This section provides a close-up look at key side effects of Xanax.

Weight gain or loss

Weight gain or loss may occur with Xanax use. Weight changes were a common side effect in studies of the drug.

Keep in mind that weight changes are a common symptom of anxiety, which Xanax is used to treat. It’s possible you may gain or lose weight while you’re taking Xanax because your anxiety is easing. Weight changes may not necessarily happen because of Xanax itself.

Tips for managing

If you’re concerned about weight gain or loss with Xanax, talk with your medical professional. They can recommend healthy ways for you to manage your weight.

Low blood pressure

Low blood pressure is possible side effect of taking Xanax. This condition was common in studies of the drug.

You may not have any symptoms of low blood pressure. But symptoms can include:

Tips for managing

If you have symptoms of low blood pressure while taking Xanax, talk with your medical professional. They may suggest that you check your blood pressure periodically with a home monitor.

Allergic reaction

Many drugs, including Xanax, can cause an allergic reaction. This side effect was reported after the drug’s initial studies were completed.

Symptoms that can occur with a mild allergic reaction may include:

  • itchiness
  • skin rash
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction may also occur, but this is rare. Symptoms of a severe allergic reaction may include swelling of your mouth, tongue, or throat, which can cause trouble breathing. You may also experience swelling under your skin, often in your lips, eyelids, hands, or feet.

Tips for managing

If you have symptoms of an allergic reaction to Xanax, be sure to call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Boxed warnings

Xanax has boxed warnings from the Food and Drug Administration (FDA). Boxed warnings appear on the drug’s label and alert you to possible serious risks.

Risk of serious injury or death if used with opioids. The use of Xanax and opioid drugs may cause severe side effects, including extreme sleepiness and respiratory depression (slow or weak breathing). Other severe side effects include coma and, in some cases, death.

Examples of opioids include oxycodone (Oxycontin, Roxicodone) and morphine (Kadian, MS Contin).

Risk of dependence and withdrawal. It’s possible to develop physical dependence with Xanax. Dependence means that your body gets used to a drug and needs the drug to feel normal.

You may have withdrawal symptoms if you suddenly stop taking Xanax. In some cases, this can be life threatening. Withdrawal symptoms from Xanax can include:

Risk of misuse and addiction. The use of Xanax may lead to misuse and addiction. Misuse means taking a drug in a way that’s different from how your medical professional recommended you take it. An addiction means continuing to take a drug even if it causes you harm. Misuse and addiction may lead to overdose, and in rare cases, death.

Misuse and addiction weren’t reported in studies of Xanax. But they have been reported with benzodiazepines, which is the group of drugs that Xanax belongs to.

Misuse and addiction may cause side effects such as:

Tips for managing

Here are some tips for managing the effects mentioned in Xanax’s boxed warnings.

Risks with opioids. Before starting Xanax treatment, tell your medical professional about all medications you take. If they recommend that you take an opioid while using Xanax, they will discuss the risks with you. They’ll typically lower your Xanax dosage to reduce your risk for side effects as much as possible.

Misuse and addiction. If you’re concerned about misuse and addiction with Xanax, talk with your medical professional. They’ll monitor your risk for these conditions before you start treatment with Xanax. They will also assess your risk from time to time while you’re taking the drug.

Dependence and withdrawal. If you’re concerned about dependence when using Xanax, talk with your medical professional.

It’s also important to talk with them before you stop Xanax treatment. If they recommend that it’s safe for you to stop taking the drug, they’ll lower your dosage gradually over time. This should help decrease your risk for withdrawal symptoms.

If you have any symptoms of withdrawal from Xanax, tell your medical professional right away. They’ll monitor your condition closely to help prevent your symptoms from becoming worse. They may recommend certain treatments to help relieve your withdrawal symptoms.

Suicide prevention

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

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Your medical professional can advise you on how much Xanax to take and how often. It’s important to follow the instructions your medical professional provides. Commonly used dosages are mentioned below, but always take the dosage your medical professional recommends.

Xanax forms and strengths (0.25 mg, 0.5 mg, 1 mg, and 2 mg)

Xanax comes as tablets you take by mouth.

The drug is available in two forms: immediate-release (Xanax) and extended-release (Xanax XR). “Immediate-release” means the drug is released quickly into your body after you take it. “Extended-release” means the drug is released slowly into your body over time.

We cover only the immediate-release form of Xanax in this article. If you’d like to learn about Xanax XR, talk with your medical professional or pharmacist.

Immediate-release Xanax comes in the following strengths: 0.25 milligrams (mg), 0.5 mg, 1 mg, and 2 mg.

What Xanax looks like

What Xanax tablets look like depends on the strength:

  • 0.25 mg: This tablet is a white oval. It’s scored down the middle on one side and says “Xanax 0.25” on the other side.
  • 0.5 mg: This tablet is a peach oval. It’s scored down the middle on one side and says “Xanax 0.5” on the other side.
  • 1 mg: This tablet is a blue oval. It’s scored down the middle on one side and says “Xanax 1.0” on the other side.
  • 2 mg: This tablet is a white rectangle with rounded corners. On one side, it’s scored in several spots and says “Xanax.” The other side says “2.”

Dosage for generalized anxiety disorder

The typical starting dosage of Xanax for generalized anxiety disorder (GAD) is 0.25 mg to 0.5 mg three times per day.

Your medical professional may increase your dosage every few days until your symptoms are well managed. They’ll ultimately prescribe the lowest dosage of Xanax that you need to relieve your anxiety symptoms. Your medical professional will also periodically check to see if you need to continue taking the drug.

In some cases, your medical professional may recommend a strength of Xanax that isn’t available from the drug manufacturer. For example, they may prescribe 3 mg of Xanax. In this situation, you might be advised to take three of the 1-mg tablets to form 3 mg.

Your medical professional may prescribe a different dosage depending on other factors, including:

  • your age
  • other health conditions you have
  • other medications you take

If you have questions about the dosage that’s right for you, talk with your medical professional.

Dosage for panic disorder

The typical starting dosage of Xanax for panic disorder is 0.5 mg three times per day.

Your medical professional may increase your dosage every few days until your symptoms are well managed. They’ll ultimately prescribe the lowest dosage of Xanax that’s needed to relieve your symptoms of panic disorder. Your medical professional will also periodically check to see if you need to continue taking the drug.

In some cases, your medical professional may recommend a strength of Xanax that isn’t available from the drug manufacturer. For example, they may prescribe 5 mg of Xanax. In this situation, you might be advised to take a combination of the 1-mg and 2-mg tablets to form 5 mg.

Your medical professional may prescribe a different dosage depending on other factors, including:

  • your age
  • other health conditions you have
  • other medications you take

If you have questions about the dosage that’s right for you, talk with your medical professional.

Find answers to some commonly asked questions about Xanax.

How long does Xanax stay in your system?

Xanax will stay in your system for about 55 hours after your last dose.

The half-life of Xanax can be used to figure out how long the drug stays in your body. A drug’s half-life is the time it takes for half of a dose of the drug to leave your system. The half-life of Xanax is about 11 hours. So it takes about 11 hours for your body to get rid of half of a dose of Xanax. Typically, it takes about four to five half-lives for a drug to leave your system entirely.

How long can I expect Xanax to last?

You’ll likely feel the effects of Xanax for several hours after each dose.

Xanax works by increasing the level of a chemical in your brain called gamma-aminobutyric acid. This results in a calming effect that helps relieve symptoms of anxiety and panic disorder.

Xanax stays in your system for about 55 hours after your last dose. (For details, see “How long does Xanax stay in your system?” right above.)

You’ll usually stop feeling the effects of Xanax before the drug is fully cleared from your system. For this reason, you’ll likely take Xanax three times per day.

If you have any questions about how long Xanax may last for you, talk with your medical professional or pharmacist.

Is Xanax an opioid?

No, Xanax isn’t an opioid. It belongs to a group of drugs called benzodiazepines.

Xanax and opioids are used to treat different conditions. Xanax is used to treat anxiety, while opioids are used to relieve pain. (Opioids are sometimes referred to as “narcotics.“)

Although Xanax and opioids work differently in your body, they can cause similar side effects. Examples include constipation and sleepiness.

Xanax and opioids can also cause changes in the size of your pupils. Xanax typically makes your pupils larger, while opioids make your pupils smaller.

For more details about how Xanax and opioids are alike and different, talk with your medical professional or pharmacist.

What does it feel like when you take Xanax?

Xanax produces a calming effect that helps relieve symptoms of anxiety and panic disorder.

When you take Xanax, you may also feel relaxation, relief of tension, and less worry than usual.

If you have other questions about what to expect with Xanax treatment, talk with your medical professional or pharmacist.

Is it safe to take Xanax with Tylenol?

Yes, it’s safe to take Xanax with acetaminophen (Tylenol). There aren’t any known safety issues with taking Xanax and Tylenol together.

But it’s best to talk with your medical professional or pharmacist before using any new drugs while taking Xanax.

Xanax use may lead to addiction, dependence, and withdrawal. In fact, Xanax has boxed warnings for these effects from the Food and Drug Administration (FDA). Boxed warnings appear on the drug’s label and alert you to possible serious risks.

Addiction means continuing to take a drug even if it’s causing you harm. Addiction is different from physical dependence. Dependence happens when your body gets used to a drug and needs the drug to feel normal.

Dependence can cause you to have withdrawal symptoms if you suddenly stop taking Xanax. In some cases, this can be life threatening. (To learn about symptoms of addiction, dependence, and withdrawal, see “Side effects: A closer look” in the “Does Xanax have side effects?” section above.)

It’s important to talk with your medical professional before you stop Xanax treatment. If they recommend that it’s safe for you to stop taking the drug, they’ll lower your dosage gradually over time. This should help decrease your risk for withdrawal symptoms.

While researching Xanax, you may wonder how the drug compares with lorazepam (Ativan), as well as other drugs. These may include clonazepam (Klonopin) and diazepam (Valium).

Xanax, lorazepam, clonazepam, and diazepam belong to a group of drugs called benzodiazepines. All these drugs are used to help relieve symptoms of anxiety.

Drugs other than benzodiazepines can also be used to treat anxiety. They work differently in your body to relieve anxiety symptoms. Examples of these alternatives include sertraline (Zoloft) and buspirone.

For more information about how Xanax compares with other drugs, you can refer to comparison articles on these medications: Ativan, clonazepam, and Valium.

You can also ask your medical professional whether any of these drugs are right for you.

It’s important to talk with your medical professional before taking Xanax. You should discuss your overall health and any medical conditions you may have.

We describe these considerations in more detail below.

Interactions

Taking certain drugs, foods, vaccines, and other substances with some medications may affect how the medication works. These effects are known as interactions.

Before you take Xanax, be sure to tell your medical professional about any other drugs you take. This includes prescription and over-the-counter medication. It’s also important to mention any herbs, supplements, and vitamins you may use. Your medical professional or pharmacist can tell you about possible interactions these substances may have with Xanax.

Interactions with drugs or supplements

Xanax can interact with several types of drugs. These drugs include:

Keep in mind that we haven’t listed all types of drugs that may interact with Xanax. Your medical professional or pharmacist can provide more details as well as information on other possible interactions.

* For details Xanax’s boxed warning about opioids, see “Side effects: A closer look” in the “Does Xanax have side effects?” section above. Boxed warnings appear on the drug’s label and alert you to possible serious risks.
† Cocaine is illegal for personal use in the United States, and Psych Central does not support the use of illegal substances. But we do support access to important health information. We mention this interaction to help you stay safe when taking Xanax.

FDA boxed warnings

Xanax has boxed warnings from the Food and Drug Administration (FDA). Boxed warnings appear on the drug’s label and alert you to possible serious risks.

Boxed warnings for Xanax include:

  • Risk of serious injury or death if used with opioids. The use of Xanax with opioids may cause severe side effects, such as extreme sleepiness and respiratory depression (slow or weak breathing).
  • Risk of dependence and withdrawal. You may develop physical dependence with Xanax. Dependence means that your body gets used to a drug and needs to have it to feel normal. This can lead to life threatening withdrawal symptoms if you suddenly stop taking Xanax.
  • Risk of misuse and addiction. The use of Xanax may lead to misuse and addiction. Misuse means taking a drug in a way that’s different from how your medical professional recommended you take it. Addiction means continuing to take a drug even if it causes you harm.

For details, see “Side effects: A closer look” in the “Does Xanax have side effects?” section above.

Other warnings

If you have certain medical conditions or other factors that affect your health, Xanax may not be the right choice for you. Before you take Xanax, discuss your health history with your medical professional. The list below includes some factors to consider.

  • Depression. Before starting Xanax treatment, tell your medical professional if you have depression. Xanax may cause worsening depression in people with this condition. Xanax can also cause mania or hypomania (periods of extreme excitement and high energy) in people with depression. If you have depression, your medical professional may prescribe a lower dosage of Xanax than usual.
  • Liver problems. If you have liver problems, your medical professional may prescribe a lower dosage of Xanax than usual. Before starting Xanax treatment, be sure to tell them about any liver problems you have.
  • Lung problems. Before starting Xanax, tell your medical professional if you have lung problems. In some cases, death has been reported in people with severe lung problems who took Xanax. If you have lung problems, your medical professional may prescribe a drug other than Xanax for you.
  • Allergic reaction. If you’ve had an allergic reaction to Xanax or any of its ingredients, you should not take Xanax. Ask your medical professional what other treatments might be better choices for you.

Xanax and alcohol

It’s not safe to drink alcohol while you’re taking Xanax.

Both Xanax and alcohol may cause central nervous system (CNS) depression. With CNS depression, your brain activity slows.

Both Xanax and CNS depression may lead to side effects such as lack of coordination and drowsiness. So your risk for these side effects is higher than usual if you drink alcohol while taking Xanax.

If you drink alcohol, talk with your medical professional. They can advise you on how to stop drinking or they may suggest treatments other than Xanax.

Xanax use while pregnant or breastfeeding

Here’s some information on Xanax, pregnancy, and breastfeeding.

Pregnancy. It may not be safe to use Xanax while you’re pregnant. The drug may cause harm in newborns who were exposed to it during pregnancy.

Possible symptoms that may occur in newborns after birth include trouble breathing and excess sleepiness.

If you take Xanax during pregnancy, consider enrolling in a pregnancy registry. Pregnancy registries collect information about the effects of a drug when it’s used during pregnancy.

To enroll in the National Pregnancy Registry for Psychiatric Medications, visit the registry’s site. You can also call 866-961-2388 or talk with your medical professional.

Breastfeeding. It isn’t safe to take Xanax while breastfeeding. This is because the drug can pass into breast milk, which can cause excess sleepiness in a child who is breastfed.

It’s possible for Xanax to be misused. In fact, Xanax has a boxed warning for this risk. Boxed warnings appear on the drug’s label and alert you to possible serious risks.

Misuse means taking a drug in a way that’s different from how your medical professional recommended you take it. Examples of misusing Xanax include snorting or smoking the drug.

Some people misuse Xanax to try to feel high. But misuse can cause effects other than feeling high, such as:

For more details about the risks of misusing Xanax, see “Side effects: A closer look” in the “Does Xanax have side effects?” section above.

It’s important that you don’t take more Xanax than your medical professional recommends. Taking more than the recommended dosage can lead to severe side effects, including coma and, in some cases, death.

Symptoms of overdose

Symptoms caused by an overdose can include:

  • confusion
  • decreased reflexes
  • feeling sleepy
  • lack of coordination

What to do in case you take too much Xanax

If you believe you’ve taken too much Xanax, call your medical professional right away. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if your symptoms are severe, immediately call 911 (or your local emergency number) or go to the closest emergency room.

Your medical professional can help explain how to take Xanax. It’s important that you take the medication only as they recommend.

Xanax comes as tablets that you take by mouth.

When to take Xanax

You’ll likely take Xanax three times per day. Try to take your doses around the same times each day. This helps your body keep a steady level of the drug so it’s most effective for treating your condition.

Tips for taking Xanax

You shouldn’t drive while taking Xanax until you know how the drug affects you.

Xanax may cause you to feel lightheaded or sleepy. It can also affect your coordination. These side effects can be dangerous if they occur while you’re driving.

Be sure to talk with your medical professional if you’re concerned about driving or doing other activities while you’re taking Xanax.

Taking Xanax with other drugs

Xanax has a boxed warning for a risk of serious injury or death if the drug is used with opioids. A boxed warning is a serious warning from the Food and Drug Administration (FDA). It appears on the drug’s label and alerts you to possible serious risks.

For details, see “Side effects: A closer look” in the “Does Xanax have side effects?” section above.

Frequently asked questions about taking Xanax

Here are some frequently asked questions about Xanax treatment:

  • What should I do if I miss a dose of Xanax? If you miss a dose of Xanax, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Then go back to your regular dosing schedule. It’s important that you don’t take an extra dose of Xanax to make up for a missed dose. The extra dose may increase your risk for side effects from the drug. If you aren’t sure whether to take a dose or skip it, talk with your medical professional or pharmacist.
  • Is Xanax meant for long-term use? Xanax isn’t typically used long term. The drug is usually prescribed for the shortest amount of time needed to relieve your symptoms. Your medical professional will tell you the right length of time to take Xanax.
  • Can you split or crush Xanax? If you have trouble swallowing Xanax tablets whole, you can split or crush Xanax. For more information on taking Xanax tablets, talk with your medical professional or pharmacist.
  • Should you take Xanax with food? You can take Xanax with or without food.
  • How long does Xanax take to “kick in”? You’ll likely start noticing the effects of Xanax within 1 to 2 hours after taking the drug.
What should you ask your medical professional?

It’s common to have questions about your treatment plan for Xanax. Your medical professional is there to work with you and help address any concerns you have.

To help guide your discussion, here are some suggestions:

  • Try writing down questions you have before your visit. For example, “How will taking Xanax affect my mood, body, and lifestyle?”
  • Think about asking a loved one or friend to come with you to your appointment. Having in-person support may help you feel more at ease.
  • Keep in mind that if your medical professional says something that’s unclear, you can always ask them to explain it.

Working with your healthcare team may help you stay on track with your treatment. The team wants you to get the best care possible.

If you have anxiety, your medical professional may recommend that you take Xanax.

Xanax is a prescription drug that’s used to treat the following conditions in adults:

  • Generalized anxiety disorder (GAD). With GAD, you have symptoms of anxiety on most days for at least 6 months. Symptoms of anxiety can include feelings of worry or intense fear about everyday situations. Xanax is used for short-term treatment of GAD.
  • Panic disorder. With this condition, you have sudden, intense symptoms of anxiety that seem to happen without being triggered. Xanax is used to treat panic disorder that occurs with or without agoraphobia. (Agoraphobia is an intense fear of being in public.)

Xanax belongs to a group of drugs called benzodiazepines. Xanax works by increasing the levels of a chemical called gamma-aminobutyric acid in your brain. This results in a calming effect that helps relieve symptoms of anxiety and panic disorder.

Note: Xanax isn’t currently approved to help with sleep. But the drug may be used off-label for this purpose. (Off-label means using a drug for a condition it hasn’t been approved to treat.)

Keep in mind that sleepiness is a possible side effect of Xanax. So it’s possible that Xanax may help you sleep. But it’s important to talk with your medical professional to learn more about using Xanax for sleep.

Xanax is a prescription drug. The costs of prescription medications may depend on several factors, such as your insurance coverage and the pharmacy you use.

If you’re wondering how to pay for Xanax, talk with your medical professional or pharmacist. You may also want to visit the website of the Xanax manufacturer to see if support options are available.

If you still have questions about Xanax after reading this article, we recommend that you talk with your medical professional. Together you can decide if Xanax might be a good choice for you.

You can also discuss other treatments, forms of support, and resources that may benefit you. We’ve listed some helpful suggestions below.

Additional treatment options

While you take Xanax, additional treatments and remedies may help you better manage your condition. These can include:

Finding support

Whether you’re looking for a therapist, support group, or information on how to afford therapy, these resources may help:

Other resources

To receive weekly information on mental health, you may want to sign up for the Psych Central newsletter. You’ll find stories directly from other people on their mental health journey as well as the latest information on treatments.

Q:

Should I take Xanax with other drugs that treat anxiety?

Anonymous patient

A:

It’s possible that your medical professional will recommend that you use Xanax together with other drugs to treat your anxiety.

Xanax is typically used for short-term treatment of generalized anxiety disorder. Your medical professional may recommend combining Xanax with long-term treatment to further manage your anxiety. Medications used for this long-term treatment can include selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft).

Keep in mind that certain drugs, when used together with Xanax, may increase your risk for side effects or decrease how well Xanax works. While you take Xanax, be sure to check with your medical professional before using any other medications.

Melissa Badowski, PharmD, MPH, FCCPAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Psych Central has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.