Why have I been prescribed Xanax?

• Xanax (Alprazolam) tablets are only used to treat severe anxiety and severe anxiety associated with depression.

How does it work?

• Xanax belongs to a group of medicines called benzodiazepines. These work by increasing the amount of a certain chemical in the brain which calms the brain down and stops the nerves firing inappropriately.

When and how do I take it?

• Xanax tablets are only used for short-term treatment (not more than 12 weeks). You will not normally be given a prescription for more than 4 weeks and you will be regularly reviewed by your doctor during this time.
• Always see your doctor before you stop taking Xanax tablets as the dose needs to be reduced gradually. If you stop taking the tablets or reduce the dose suddenly you can get ‘rebound’ effects which might cause you to become temporarily more anxious or restless or to have difficulty sleeping.

What’s the dose?

Adults

• You will usually start by taking a dose of 500 micrograms to 1 mg.
• This medicine is taken in divided doses two or three times daily.
• This dose may be increased gradually up to a total of 3mg to 4mg again taken in divided doses throughout the day.
• Where the dose does need to be increased, it is usual to increase the night time dose first, before the daytime doses to make sure you are more alert during the day. Taking the medicine at bedtime also reduces the risk of having memory problems. If you start to get side effects the doctor may lower your dose.

The elderly

• If you are an older patient or you have for example kidney or liver problems and you need a lower dose you will normally start on a dose of 250 micrograms twice a day. This dose may be slowly increased if needed and if you don’t get any side effects.

Could it interact with other tablets?

Tell your doctor or pharmacist if you are taking any of the following medicines, as the effect of Xanax may be stronger when taken at the same time:

• any other medicines to treat anxiety or depression or to help you sleep;
• some strong pain killers (e.g. morphine or codeine);
• antipsychotic medicines used to treat mental illnesses like schizophrenia;
• medicines to treat epilepsy;
• antihistamines for relief of allergies;
• medicines for treating fungal infections (e.g. ketoconazole);
• oral contraceptives (‘the pill’);
• certain antibiotics (e.g. erythromycin);
• cimetidine (for treating stomach ulcers);
• diltiazem (used for angina and high blood pressure);
• ritonavir or other similar medicines used for treating HIV;
• if you are going to have an operation where you will be given a general anaesthetic, tell your doctor or anaesthetist that you are taking Xanax.

Herbal products should also only be taken after talking with your doctor.

What are the possible risks or side-effects?

Like all medicines Xanax can cause side effects although not everyone gets them, and if you do get them they may differ in intensity for different people.

Reasons for seeing your doctor immediately:

• Very occasionally treatment with Xanax can cause serious behavioural or psychiatric effects - for example agitation, restlessness, aggressiveness, irritability, violent anger, false beliefs, nightmares and hallucinations or other inappropriate behaviour.
• Sudden wheeziness, difficulty in swallowing or breathing, swelling of eyelids, face or lips, rash or itching (especially affecting the whole body).
• if you get any of these symptoms see your doctor straight away as treatment will need to be discontinued. Your doctor will then advise how treatment will be stopped.

Reasons for seeing your doctor as soon as possible

Tell your doctor as soon as possible if you get the following symptoms as your dose or treatment might need to be changed:

• memory loss (amnesia) or
• yellowing of the skin and whites of the eyes (jaundice).

Dependence and withdrawal symptoms:

It is possible to become dependent on medicines like Xanax while you are taking them which increases the likelihood of getting withdrawal symptoms when you stop treatment.

Withdrawal symptoms are more common if you:

• stop treatment suddenly
• have been taking high doses
• have been taking for long time
• have a history of alcohol or drug abuse.

This can cause effects such as headaches, muscle pain, extreme anxiety, tension, restlessness, confusion, mood changes, difficulty sleeping and irritability. In severe cases of withdrawal you can also get the following symptoms: nausea (feeling sick), vomiting, sweating, stomach cramps, muscle cramps, a feeling of unreality or detachment, being unusually sensitive to sound, light or physical contact, numbness and tingling of the feet and hands, hallucinations (seeing or hearing things which are not there while you are awake), tremor or epileptic fits. Please tell your doctor if any withdrawal symptoms get worse or don’t go away.

Other side effects that may occur are:

• Loss of alertness or concentration.
• Tiredness.
• Insomnia (inability to sleep or disturbed sleep).
• Sleepiness and unsteadiness (similar to feeling drunk) especially during the day.
• Light-headedness.
• Nervousness or feeling anxious.
• Confusion.
• Double or blurred vision.
• Increased pressure in the eyes, which can also affect your vision.
• Shakiness or trembling.
• Slurred speech.
• Stomach upsets.
• Loss of appetite or change in your weight.
• Muscle spasms or weakness.
• Jerky, uncoordinated movements.
• Headaches.
• Difficulty urinating or bladder control problems.
• Dizziness.
• Skin reactions.
• Problems with liver function (this shows up in blood tests).
• In women, irregular periods or production of too much prolactin (the hormone that stimulates milk production).
• Changes in your sex drive (men and women).

Can I drink alcohol while taking it?

• Do not drink alcohol with this medicine.

What if I’m pregnant/breastfeeding?

• Xanax may be harmful to the developing baby so you should not take Xanax if you are pregnant or planning to become pregnant. Tell your doctor immediately if you think you may be pregnant.
• Do not breast-feed while taking Xanax, as the drug may pass into breast milk.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.patient.co.uk/leaflets/xanax.htm

http://en.wikipedia.org/wiki/Alprazolam

http://www.drugs.com/xanax.html

http://www.webmd.com/drugs/drug-9824-Xanax+Oral.aspx?drugid=9824&drugname=Xanax+Oral

http://www.rxlist.com/xanax-drug.htm

http://www.news-medical.net/drugs/Xanax.aspx