For all users of Xanax:
To ensure the safe and effective use of benzodiazepines, all patients prescribed with Xanax will be provided with the following guidance:
- Inform your doctor about any alcohol consumption and medicine you are currently taking, including over-the-counter (OTC) medication. Alcohol should generally not be used during treatment with benzodiazepines.
- Xanax is not recommended for use in pregnancy. Inform your doctor if you are pregnant, if you are planning to have a child, or if you become pregnant while you are taking this medication.
- Inform your doctor if you are breastfeeding.
- Until you experience how Xanax affects you, do not drive a car or operate heavy or dangerous machinery.
- Do not increase the dose of Xanax without speaking with a doctor, even if you think the medication “does not work anymore.” Benzodiazepines, even when used as recommended, may produce emotional and physical dependence.
- Do not stop taking Xanax abruptly or decrease the dose without consulting your doctor because withdrawal symptoms can occur.
Inform your doctor if you have asthma or other breathing problems, glaucoma, kidney, or liver diseases, history of alcoholism or depression, suicidal thoughts, or an addiction to drugs or alcohol.
You should not take Xanax if you:
- Have narrow-angle glaucoma.
- Are also taking itraconazole (Sporanox) or ketoconazole (Nizoral).
- Are allergic to Xanax or other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).
In certain individuals, the body handles Xanax differently, these include:
- people with alcoholism
- individuals with alcoholic liver disease
- individuals with impaired hepatic function
- individuals with impaired renal function
- older adults
- people who are obese
Do not use Xanax if you are allergic to alprazolam or other benzodiazepines such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).
Do not drink alcohol while taking Xanax. Xanax can increase the effects of alcohol.
Do not use Xanax if you are pregnant. Benzodiazepines can potentially cause harm to the fetus. Xanax increases the risk of congenital abnormalities when given to a pregnant woman during the first trimester.
Use of Xanax during the first trimester of pregnancy should usually be avoided.
Patients should be advised that if they become pregnant during therapy or intend to become pregnant, they should tell their doctor.
A child born of a mother who is taking benzodiazepines may be at risk of withdrawal symptoms from the drug. Also, respiratory problems have been reported in children born to mothers who have been taking benzodiazepines.
It is thought that Xanax is excreted in human milk. As a general rule, mothers who must use Xanax should not breast-feed.
Xanax has not been studied in children.
Gender does not affect the body’s response to Xanax.
Older adults may be more sensitive to the effects of benzodiazepines. The sedative effects of Xanax may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking Xanax.
Xanax may affect Asian populations more than white populations.
Xanax concentrations may be reduced up to 50 percent in smokers, compared with nonsmokers.
As with other psychotropic medications, there are precautions when giving the drug to severely depressed patients or those who may have suicidal thoughts.
Episodes of hypomania and mania have been reported in association with the use of Xanax in patients with depression.
Xanax is often abused for the fast-acting, relaxed “high” it can give to people who take it, including people without a prescription.
According to the Treatment Episode Data Set, the number of individuals seeking treatment for benzodiazepine abuse almost tripled from 1998-2008. Long-term abuse and addiction to Xanax are associated with depression, psychotic experiences, and aggressive or impulsive behavior.
According to the Substance Abuse and Mental Health Services Administration, in 2011, there was over 1.2 million emergency department (ER) visits overall related to the nonmedical use of prescription drugs – Xanax was involved in 10 percent of those visits.
The number of emergency department visits involving the non-medical use of the sedative Xanax doubled from 57,419 to 124,902 during the years 2005 to 2010 and then remained stable at 123,744 in 2011.
The most common drug combinations encountered in ER patients are Xanax and alcohol, and Xanax combined with prescription opiates like hydrocodone and oxycodone.
Xanax is used to manage anxiety disorder or the short-term relief of symptoms of anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment.
Generalized anxiety disorder is characterized by unrealistic or excessive anxiety and worries about two or more life circumstances, for a period of 6 months or longer, during which the person has been bothered more days than not by these concerns.
At least six of the following symptoms are often present in these patients:
- Motor tension: trembling, twitching, feeling shaky, muscle tension, aches or soreness, restlessness, easily tired.
- Autonomic hyperactivity: shortness of breath or smothering sensations, palpitations or accelerated heart rate, sweating, or cold, clammy hands, dry mouth, dizziness or light-headedness, nausea, diarrhea, or other abdominal distress, flushes or chills, frequent urination, trouble swallowing or a “lump in the throat.”
- Vigilance and scanning: feeling keyed up or on edge, exaggerated startle response, difficulty concentrating or “mind going blank” because of anxiety, trouble falling or staying asleep, irritability.
Xanax is also indicated for the treatment of panic disorder, with or without agoraphobia, and may reduce the number of panic attacks experienced.
Panic disorder is characterized by regular panic attacks. Panic attacks are relatively short periods of intense fear or discomfort where four or more of the following symptoms develop all of a sudden and reach a peak within 10 minutes:
- Palpitations, pounding heart, or accelerated heart rate.
- Trembling or shaking.
- Sensations of shortness of breath or smothering.
- Feeling of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Feeling dizzy, unsteady, lightheaded, or faint.
- Derealization (feelings of unreality) or depersonalization (being detached from oneself).
- Fear of losing control.
- Fear of dying.
- Paresthesia (numbness or tingling sensations).
- Chills or hot flushes