See Supplemental Patient Information
- Dependence and withdrawal reactions including seizures have occurred. Life-threatening reactions have occurred as a result of direct consequence of physical dependence. Some risk of dependence exists even with relatively short-term therapy. Risk of dependence and its severity is greater in patients treated with doses of >4 mg/day and in those treated over long periods of time.
- Risk of dependence among panic disorder patients is higher than that among those treated for less severe anxiety
- Heightened sensory perception, impaired concentration, dysosmia, clouded sensorium, paresthesias, muscle cramps, muscle twitch, diarrhea, blurred vision, appetite decrease, and weight loss have occurred as symptoms of withdrawal. Anxiety and insomnia have occurred following discontinuation of therapy.
- Seizures have occurred following abrupt dose reduction or discontinuation from daily doses of 2 - 10 mg. Risk of seizure is greatest for 24 - 72 hrs after discontinuation. Multiple seizures and status epilepticus have also occurred following discontinuation of therapy
- Early morning anxiety and emergence of anxiety symptoms between doses have occurred in patients with panic disorder taking prescribed maintenance doses. Administer same total daily dose in divided doses as more frequent administration to maintain plasma levels for prevention of relapse, rebound or withdrawal symptoms over the entire course of the interdosing interval
- Reduce dosage or discontinue therapy gradually as risk of withdrawal reactions exists
- Fetal harm has occurred on administering to pregnant women; congenital abnormalities have occurred when administered to a pregnant woman during the first trimester. Avoid use during the first trimester of pregnancy
- Avoid therapy in patients receiving very potent inhibitors of CYP3A. Cautiously use therapy and consider appropriate dosage reduction in patients receiving drugs inhibiting CYP3A to a lesser but still significant degree
- Therapy exhibits weak uricosuric effect
- Episodes of hypomania and mania have occurred in patients with depression
- Use lowest effective dose to reduce the incidence of ataxia or over sedation
- Rare occasions of death have occurred in patients with severe pulmonary disease shortly after the initiation of therapy
- Increased plasma half-life may occur in alcoholic liver disease patients and obese patients
- Periodically perform blood counts, urinalysis, and blood chemistry
Cautions: Use cautiously in:
- Renal impairment
- Hepatic impairment
- Elevated gastric pH (ODT)
- Decreased salivary flow (ODT)
- Pulmonary impairment
- Sleep apnea
- CNS depression
- Depression
- Use of alcohol
- History of alcohol or drug abuse
- History of seizure
- Phenylalanine-containing forms
- Changes in smoking habits
- Geriatrics
- Debilitated patients
Supplemental Patient Information
- Advice patients against engaging in hazardous occupations or activities requiring complete mental alertness such as operating machinery or driving a motor vehicle
- Caution patients against simultaneous ingestion of alcohol and other CNS depressant drugs during therapy
- Warn patients about the potential hazard to the fetus if the drug is used during pregnancy
- Advise patients to communicate with their physicians if they become pregnant during therapy or intend to become pregnant
- Inform patients that the therapy exhibits potential to cause severe emotional and physical dependence
Pregnancy Category:D
Breastfeeding: Possibly unsafe; effects in infants, including sedation have been reported. Breast fed infants receive a dose of 0.5-5 mcg/kg/day or about 3% of the maternal weight adjusted dosage. A shorter acting benzodiazepine without active metabolites is preferred based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 4 January 2011). Benzodiazepines are excreted in human milk; infants may lose weight and become lethargic due to maternal doses. Manufacturer advises that nursing women should not use alprazolam.
Pricing data from www.DrugStore.com in U.S.A.
- Xanax 0.5 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $64.99
90 mg = $179.97 - Xanax 2 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $129.99
90 mg = $362.96 - ALPRAZolam 1 MG TBDP [Box] (PAR)
30 mg = $69.99
90 mg = $195.97 - Xanax XR 2 MG TB24 [Bottle] (PFIZER U.S.)
30 mg = $161.68
90 mg = $463.03 - ALPRAZolam 0.5 MG TABS [Bottle] (GREENSTONE)
30 mg = $12.99
60 mg = $15.97 - Xanax 1 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $85.99
90 mg = $230.98 - Xanax XR 1 MG TB24 [Bottle] (PFIZER U.S.)
30 mg = $122.84
90 mg = $355.9 - Xanax XR 3 MG TB24 [Bottle] (PFIZER U.S.)
30 mg = $229.95
90 mg = $658.3 - Niravam 0.25 MG TBDP [Bottle] (AZUR PHARMA)
30 mg = $103.58
90 mg = $274.17 - ALPRAZolam 0.25 MG TABS [Bottle] (GREENSTONE)
30 mg = $11.99
90 mg = $15.97 - Niravam 0.5 MG TBDP [Bottle] (AZUR PHARMA)
30 mg = $136.99
90 mg = $361.98 - ALPRAZolam 0.5 MG TB24 [Bottle] (ACTAVIS ELIZABETH)
30 mg = $31.99
90 mg = $71.98 - ALPRAZolam 0.25 MG TBDP [Box] (PAR)
30 mg = $43.99
90 mg = $119.97 - Niravam 2 MG TBDP [Bottle] (AZUR PHARMA)
30 mg = $255.9
90 mg = $710.95 - ALPRAZolam 2 MG TABS [Bottle] (GREENSTONE)
30 mg = $15.99
60 mg = $18.97 - Xanax 0.25 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $56.99
90 mg = $144.97 - ALPRAZolam 1 MG TABS [Bottle] (GREENSTONE)
30 mg = $12.99
60 mg = $14.98 - Niravam 1 MG TBDP [Bottle] (AZUR PHARMA)
30 mg = $178
90 mg = $490.96 - Xanax XR 0.5 MG TB24 [Bottle] (PFIZER U.S.)
30 mg = $98.99
90 mg = $282.4
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.