Key takeaways

  • Alprazolam can cause side effects that range from mild to serious. More common side effects include drowsiness, fatigue (low energy), and dizziness.
  • If alprazolam side effects become difficult to tolerate, talk with your doctor about managing tips or other treatment options.
  • Alprazolam also has boxed warnings for risk of serious side effects if taken with opioids, risk of misuse and addiction, and risk of withdrawal and dependence. Be sure to talk with your doctor about your medical history before starting the medication.

Alprazolam is a generic prescription drug used in adults for:

Keep reading to learn about the common, mild, and serious side effects alprazolam can cause.

Alprazolam has has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Boxed warnings for alprazolam” section.

Some people may experience mild to serious side effects during their alprazolam treatment. Examples of the drug’s more commonly reported side effects include:

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Mild side effects have been reported with alprazolam. These include:

In most cases, these side effects should be temporary, and some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking alprazolam unless your doctor recommends it.

Alprazolam may cause mild side effects other than those listed above. See the prescribing information for alprazolam tablets, orally disintegrating tablets, and extended-release tablets for details.

For more information about some of these side effects, see “Tips for managing side effects.”

Serious side effects have been reported with alprazolam. These include:

  • depression
  • depersonalization (a sense of unreality or feeling detached from yourself)
  • heart problems, including chest pain and changes to your heartbeat
  • blurred or double vision
  • movement problems, including uncontrolled muscle movements or muscle tremors
  • reduced ability to safely perform dangerous activities such as driving or operating machines
  • seizures
  • liver problems, such as jaundice (yellowing of your skin or the whites of your eyes)
  • risk of severe side effects when taken with opioids (see “Boxed warnings for alprazolam”)
  • risk of dependence and withdrawal symptoms (see “Boxed warnings for alprazolam”)
  • risk of misuse and addiction (see “Boxed warnings for alprazolam”)
  • hallucinations (see “Tips for managing side effects”)

If you develop serious side effects while taking alprazolam, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect during treatment with alprazolam and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

For some people, alprazolam can cause an allergic reaction.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue alprazola treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to alprazolam, they may have you switch to a different treatment.

Get answers to some frequently asked questions about alprazolam’s side effects.

Yes, they might. In general, people ages 65 years and older are more likely to have side effects with alprazolam than younger people.

In particular, older people are more likely to have memory loss and concentration problems with alprazolam. They’re also more likely to have drowsiness and problems with coordination and balance. And these side effects can increase the risk of falls in older people.

Doctors usually prescribe a lower dosage of alprazolam for those ages 65 years and older to help reduce the risk of side effects.

You might, but other factors can also affect your risk of dependence. Alprazolam has a boxed warning about the risk of dependence. (See the “Boxed warnings for alprazolam” section for details.) With dependence, your body gets used to a drug and needs it for you to function as usual. Suddenly stopping a drug that you’re dependent on can cause withdrawal symptoms.

Taking a high dose of alprazolam is more likely to lead to dependence than taking a low dose, such as 0.25 milligrams (mg), 0.5 mg, or 1 mg. But the length of time you take alprazolam also affects your risk. The longer someone takes this drug, the more likely they are to become dependent on it. Other factors may also affect your risk of dependence.

If you’re concerned about your risk of dependence with the alprazolam dosage you’ve been prescribed, talk with your doctor.

No, kidney-related side effects weren’t reported in studies of alprazolam. Your kidneys help remove alprazolam from your body, so if you have kidney problems, the drug could build up in your system. This could increase your risk of side effects. But alprazolam isn’t known to damage your kidneys or affect how they work.

Yes, it’s possible to develop long-term side effects with alprazolam, but it’s rare. Most of alprazolam’s side effects are temporary and get better soon after you stop taking the drug.

Side effects that may last for a long time after you stop alprazolam treatment include liver problems and weight changes.

Some people may also have long-term withdrawal symptoms after stopping alprazolam. (Alprazolam has a boxed warning for the risk of dependence and withdrawal. See the “Boxed warnings for alprazolam” section for details.)Withdrawal symptoms are side effects that can occur if you suddenly stop taking a drug that your body depends on. (With dependence, your body gets used to a drug and needs it to function as usual.)

Some people have had withdrawal symptoms that lasted for weeks to longer than a year after stopping alprazolam. But this isn’t common.

If you’re concerned about long-term side effects with alprazolam, talk with your doctor.

Alprazolam has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Risk of severe side effects when taken with opioids

Alprazolam has a boxed warning for the risk of severe side effects when taken with opioids.Opioids are powerful drugs that include:

Both alprazolam and opioids slow activity in your central nervous system (brain and spinal cord). Taking alprazolam with opioids can cause severe side effects that can lead to coma and even death. These side effects include:

If you have any of these symptoms, you or another person should call 911 or your local emergency number immediately.

Due to the risks of taking alprazolam with opioids, your doctor will only prescribe these drugs together if there are no suitable options. And they’ll use the lowest possible dose of both drugs that work to treat your condition.

What might help

If your doctor recommends taking alprazolam with an opioid, there are a few things you can do to minimize the risks:

  • Tell your caregiver, the people you live with, and people close to you that you’re taking these drugs together.
  • Know what side effects to look out for and when you or another person should get emergency medical help.
  • Never drink alcohol with this combination of drugs.
  • Never take these drugs in a higher dose or more often than prescribed.
  • Talk with your doctor about keeping a supply of Narcan (naloxone), a nasal spray that can be used in an emergency to block the effects of opioids.

Risk of misuse and addiction

Alprazolam has a boxed warning for the risk of misuse and addiction. Alprazolam is a benzodiazepine drug that has calming and relaxing effects. Some people may misuse the drug for this reason. (With misuse, a person uses a drug in a way or for a reason other than how a doctor prescribes it.)

Misuse of alprazolam can cause serious side effects, overdose, and even death. It can also lead to addiction, in which the drug is taken even if it’s causing harmful effects.

What might help

Due to these risks, the federal government has classified alprazolam as a controlled substance. This means government agencies, doctors, and pharmacists may pay close attention to how the drug is prescribed and used.

You should only take alprazolam exactly as prescribed by your doctor. Do not take it in a higher dose, more often, or for a longer period of time than your doctor recommends. You should also be sure to keep the drug in a safe place to avoid it being misused by other people.

Risk of dependence and withdrawal symptoms

Alprazolam has a boxed warning for the risk of dependence and withdrawal symptoms.

Taking alprazolam can lead to dependence on the drug. This is when your body gets used to a drug and needs it to function as usual. Stopping alprazolam suddenly or having your dose lowered too quickly can cause withdrawal symptoms (sometimes called a withdrawal syndrome). These are side effects caused by suddenly stopping or taking too little of a drug.

These withdrawal symptoms can be mild, serious, or even life threatening. Examples include:

Withdrawal symptoms are more likely if you suddenly stop alprazolam after taking it at a high dose or for a long period of time. But in some cases, it’s also possible to have withdrawal symptoms after just missing a dose.

Rarely, some people have experienced withdrawal symptoms lasting weeks or longer than a year after stopping alprazolam.

What might help

To avoid withdrawal symptoms, do not suddenly stop taking alprazolam. When you and your doctor determine you should stop treatment, your doctor will usually reduce your dosage gradually over time. This is called a dose taper. It’s usually done over a few weeks and allows your body to adjust to being without the drug in your system.

If you have withdrawal symptoms during your dose taper, talk with your doctor. They may recommend increasing your dosage again and then decreasing it more slowly.

If you’re concerned about alprazolam dependence and withdrawal, talk with your doctor.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

There may be things you can do to help make certain alprazolam side effects more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other available treatment options for your condition.

Weight gain

Some people may have weight gain while taking alprazolam, but this side effect was rare in studies.

Alprazolam can also cause weight loss in some people.

This is because the drug can cause changes in your appetite that may lead to weight changes. And the anxiety disorders alprazolam is used to treat can also cause changes in your appetite and weight.

What might help

If you’re concerned about weight gain with alprazolam, talk with your doctor. They can recommend ways to maintain a weight that’s healthy for you.

Nausea

You may have nausea while taking alprazolam. This side effect was common in studies of the drug. But nausea can also be a symptom of anxiety, which alprazolam is used to treat.

What might help

If you have nausea with alprazolam, it may help to take it with food. It may also help to:

  • get plenty of fresh air
  • breathe deeply
  • drink ginger or peppermint tea
  • eat little and often rather than large main meals

If you have nausea that’s severe, bothersome, or doesn’t go away, talk with your doctor.

Hallucinations

Some people may have hallucinations while taking alprazolam. (With hallucinations, you may see, hear, smell, or sense things that aren’t really there.) But this side effect was rare in studies of the drug. Some people have also had hallucinations after suddenly stopping alprazolam.

You may have an increased risk of hallucinations if you take alprazolam with alcohol or other drugs that slow activity in your central nervous system. (This includes your brain and spinal cord.) People with certain mental health problems may also have an increased risk of hallucinations with alprazolam.

What might help

If you have hallucinations while taking alprazolam, talk with your doctor right away. They’ll likely recommend that you stop taking the drug. But do not suddenly stop taking alprazolam unless recommended by your doctor, as this could cause withdrawal symptoms. (For more information, see the “Boxed warnings for alprazolam” section.)

Consider the following important information before starting alprazolam.

Alprazolam has has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Boxed warnings for alprazolam” section.

Other warnings

Before taking alprazolam, discuss your health history with your doctor. Alprazolam may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

Alprazolam has some common side effects, which are usually mild. But there are some serious risks to consider with this drug. If you have questions about side effects that alprazolam can cause, talk with your doctor.

You can also ask them about Xanax, which is the brand-name version of alprazolam. A generic drug and its brand-name version are expected to have the same side effects because they contain the same active ingredient. An active ingredient is what makes a drug work.

Examples of questions you might want to ask your doctor include:

  • Do I have a high risk of becoming dependent on alprazolam?
  • Can alprazolam cause sexual side effects?
  • How long do the effects of alprazolam last?
  • Is it safe to take alprazolam with my other medications?

Disclaimer: Healthline 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.