XANAX
Generic Name: alprazolam (al PRAH zoe lam)
Brand Names: Xanax, Xanax XR

What is the most important information I should know about alprazolam?
• Use caution when driving, operating machinery, or performing other hazardous activities. Alprazolam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities.
• Avoid alcohol while taking alprazolam. Alcohol may increase drowsiness and dizziness caused by alprazolam.
• Do not crush, chew, or break the extended-release form alprazolam (Xanax XR). Swallow them whole. These tablets are specially formulated to release the medication slowly in the body.
• Alprazolam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if alprazolam is stopped suddenly after several weeks of continuous use. Seizures may be a side effect of sudden discontinuation of the medication. Your doctor may recommend a gradual reduction in dose.

What is alprazolam?
• Alprazolam is in a class of drugs called benzodiazepines. Alprazolam affects chemicals in the brain that may become unbalanced and cause anxiety.
• Alprazolam is used to relieve anxiety, nervousness, and tension associated with anxiety disorders. Alprazolam is also used to treat panic disorders.
• Alprazolam may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking alprazolam?
• Do not take alprazolam if you have narrow-angle glaucoma. Alprazolam may worsen this condition.
• Before taking this medication, tell your doctor if you
· have kidney disease;
· have liver disease;
· have a history of alcohol or drug abuse;
· have asthma, bronchitis, emphysema, or another respiratory disease;
· are depressed or have suicidal thoughts; or
· have mania, bipolar disorder, or another psychiatric condition (other than anxiety or panic disorder).
• You may not be able to take alprazolam, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Alprazolam is in the FDA pregnancy category D. This means that alprazolam is known to be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• It is not known whether alprazolam passes into breast milk. Do not take alprazolam without first talking to your doctor if you are breast-feeding a baby.
• If you are over 65 years of age, you may be more likely to experience side effects from alprazolam. Your doctor may prescribe a lower dose of the medication.

How should I take alprazolam?
• Take alprazolam exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Do not crush, chew, or break the extended-release form alprazolam (Xanax XR). Swallow them whole. These tablets are specially formulated to release the medication slowly in the body.
• Do not take more of the medication than is prescribed for you.
• Alprazolam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if alprazolam is stopped suddenly after several weeks of continuous use. Seizures may be a side effect of sudden discontinuation of the medication. Your doctor may recommend a gradual reduction in dose.
• Store alprazolam at room temperature away from moisture and heat.

What happens if I miss a dose?
• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous.

What happens if I overdose?
• Seek emergency medical attention if an overdose is suspected.
• Symptoms of an alprazolam overdose include sleepiness, dizziness, confusion, a slow heart beat, difficulty breathing, difficulty walking and talking, an appearance of being drunk, and unconsciousness.

What should I avoid while taking alprazolam?
• Use caution when driving, operating machinery, or performing other hazardous activities. Alprazolam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities.
• Avoid alcohol while taking alprazolam. Alcohol may increase drowsiness and dizziness caused by alprazolam.
• Alprazolam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor.

Generalized anxiety disorder is characterized by unrealistic or excessive anxiety and worry (apprehensive expectation) about two or more life circumstances, for a period of six months or longer, during which the person has been bothered more days than not by these concerns. At least 6 of the following 18 symptoms are often present in these patients: Motor Tension: Trembling, twitching, or feeling shaky; muscle tension, aches, or soreness; restlessness; easy fatigability. Autonomic Hyperactivity: Shortness of breath or smothering sensations; palpitations or accelerated heart rate; sweating, or cold clammy hands; dry mouth; dizziness or lightheadedness; nausea, diarrhea, or other abdominal distress; flushes or chills; frequent urination; trouble swallowing or 'lump in 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. These symptoms must not be secondary to another psychiatric disorder or caused by some organic factor.

Anxiety associated with depression is responsive to alprazolam.

Alprazolam is also indicated for the treatment of panic disorder, with or without agoraphobia.

Studies supporting this claim were conducted in patients whose diagnoses corresponded closely to the DSM-III-R criteria for panic disorder (see CLINICAL STUDIES).

Panic disorder is an illness characterized by recurrent panic attacks. The panic attacks, at least initially, are unexpected. Later in the course of this disturbance certain situations (e.g., driving a car or being in a crowded place) may become associated with having a panic attack. These panic attacks are not triggered by situations in which the person is the focus of others' attention (as in social phobia). The diagnosis requires four such attacks within a four week period, or one or more attacks followed by at least a month of persistent fear of having another attack. The panic attacks must be characterized by at least four of the following symptoms: dyspnea or smothering sensations; dizziness, unsteady feelings, or faintness; palpitations or tachycardia; trembling or shaking; sweating; choking; nausea or abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest pain or discomfort; fear of dying; fear of going crazy or of doing something uncontrolled. At least some of the panic attack symptoms must develop suddenly, and the panic attack symptoms must not be attributable to some known organic factors. Panic disorder is frequently associated with some symptoms of agoraphobia.

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