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Commonly reported side effects of alprazolam include: ataxia, cognitive dysfunction, constipation, depression, difficulty in micturition, drowsiness, dysarthria, fatigue, headache, memory impairment, menstrual disease, nervousness, sedated state, skin rash, tremor, weight gain, weight loss, anxiety, blurred vision, diarrhea, insomnia, decreased libido, increased appetite, irritability, and decreased appetite. Other side effects include: depersonalization, hyperventilation, hypoesthesia, hypotension, paresthesia, sexual disorder, sialorrhea, muscle twitching, and increased libido. See below for a comprehensive list of adverse effects.
For the ConsumerApplies to alprazolam: oral solution, oral tablet, oral tablet disintegrating, oral tablet extended release
Oral route (Tablet)
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for patients with inadequate treatment options. Limit dosages and durations to the minimum required and follow patients for signs and symptoms of respiratory depression and sedation.
Along with its needed effects, alprazolam may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking alprazolam:
More common
Less common
Rare
Incidence not known
Some side effects of alprazolam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Rare
Incidence not known
For Healthcare Professionals
Applies to alprazolam: compounding powder, oral concentrate, oral solution, oral tablet, oral tablet disintegrating, oral tablet extended release
GeneralImmediate-release formulations: The most commonly reported side effects included drowsiness/sedation, fatigue and tiredness, impaired coordination, memory impairment, and irritability.
Extended-release tablets: The most commonly reported side effects included sedation, tremor, headache, insomnia, and somnolence.
Nervous systemImmediate-release formulations:
Very common (10% or more): Sedation (up to 77%), drowsiness (up to 76.8%), impaired coordination (up to 40.1%), memory impairment (up to 33.1%), dizziness (up to 29.8%), lightheadedness (up to 29.8%), headache (up to 29.2%), cognitive disorder (up to 29%), dysarthria (up to 23.3%), abnormal voluntary movement (up to 17.3%)
Common (1% to 10%): Abnormal coordination, akathisia, ataxia, attention disturbance, balance disorder, hypersomnia, lethargy, paresthesia, somnolence, syncope, tremor, vasomotor disturbances
Uncommon (0.1% to 1%): Amnesia, autonomic manifestations, coordination disorders, intellectual impairment, stimulation
Frequency not reported: Concentration difficulties, convulsions, dystonia, loss of coordination, seizures, sleepiness, slurred speech, taste alterations, transient amnesia, withdrawal seizures
Postmarketing reports: Autonomic nervous system imbalance, psychomotor hyperactivity
Extended-release tablets:
Very common (10% or more): Sedation (up to 45.2%), tremor (up to 28.2%), headache (up to 26.5%), somnolence (up to 23%), memory impairment (up to 15.4%), dysarthria (up to 10.9%)
Common (1% to 10%): Abnormal coordination, ataxia, balance impaired, disturbance in attention, dizziness, dyskinesia, hypersomnia, hypoesthesia, lethargy, mental impairment, paresthesia, vertigo
Uncommon (0.1% to 1%): Amnesia, clumsiness, depressed level of consciousness, hangover, hypotonia, stupor, syncope
Frequency not reported: Stimulation, withdrawal seizures
OtherImmediate-release formulations:
Very common (10% or more): Fatigue and tiredness (up to 49%)
Common (1% to 10%): Feeling warm, tinnitus, weakness
Frequency not reported: Rebound phenomena
Extended-release tablets:
Very common (10% or more): Fatigue (up to 13.9%)
Common (1% to 10%): Malaise, road traffic accident, weakness
Uncommon (0.1% to 1%): Asthenia, ear pain, fall, feeling drunk, feeling hot and cold, feeling jittery, feeling of relaxation, increased energy, loss of control of legs, pyrexia, rigors, sluggishness, tinnitus
Frequency not reported: Paradoxical reactions
PsychiatricImmediate-release formulations:
Very common (10% or more): Irritability (up to 33.1%), insomnia (up to 29.5%), anxiety (up to 19.2%), decreased libido (up to 14%), depression (up to 13.9%), confusional state (up to 10.4%)
Common (1% to 10%): Agitation, change in libido (not specified), confusion, derealization, disinhibition, disorientation, dream abnormalities, fear, increased libido, nervousness, talkativeness
Uncommon (0.1% to 1%): Adverse behavioral effects, altered mood, concentration difficulties, hallucinations
Rare (0.01% to 0.1%): Hypomania, mania, other adverse behavioral effects
Frequency not reported: Abuse, aggressive or hostile behavior, aggressiveness/aggression, anterograde amnesia, delusion, depersonalization, dysphoria/mild dysphoria, hostility, inappropriate behavior, intrusive thoughts, nightmares, physical dependence, primary/secondary major depressive disorders, psychic dependence, psychoses, rage, restlessness, suicide, withdrawal symptoms
Postmarketing reports: Abnormal thinking, anger, libido disorder
Extended-release tablets:
Very common (10% or more): Insomnia (up to 24.2%), nervousness (up to 21.8%), depression (up to 12.1%)
Common (1% to 10%): Agitation, anxiety, confusion, depersonalization, depressed mood, derealization, disorientation, irritability, libido decreased/increased, nightmare, restlessness
Uncommon (0.1% to 1%): Abnormal dreams, aggression, anger, apathy, bradyphrenia, euphoric mood, hallucination, homicidal ideation, hypomania, impulse control, logorrhea, mania, mood swings, psychomotor retardation, sleep talking, suicidal ideation
Frequency not reported: Adverse behavioral effects, aggressive/hostile behavior, hostility, intrusive thoughts, other adverse behavioral effects, sleep disturbances, rage, withdrawal syndrome
GastrointestinalImmediate-release formulations:
Very common (10% or more): Decreased salivation (up to 32.8%), constipation (up to 26.2%), nausea (up to 22%), vomiting (up to 22%), diarrhea (up to 20.6%), abdominal distress (up to 18.3%), dry mouth (up to 15%)
Common (1% to 10%): Increased salivation
Uncommon (0.1% to 1%): Gastrointestinal symptoms/various gastrointestinal symptoms
Frequency not reported: Abdominal cramps
Postmarketing reports: Gastrointestinal disorder
Extended-release tablets:
Very common (10% or more): Diarrhea (up to 12.1%), dry mouth (up to 10.2%)
Common (1% to 10%): Abdominal pain, constipation, dyspepsia, nausea, vomiting
Uncommon (0.1% to 1%): Dysphagia, salivary hypersecretion
Postmarketing reports: Gastrointestinal disorder
MetabolicImmediate-release formulations:
Very common (10% or more): Increased appetite (up to 33%), decreased appetite (up to 28%), weight gain (up to 27%), weight loss (up to 23%)
Frequency not reported: Anorexia
Extended-release tablets:
Common (1% to 10%): Anorexia, appetite decreased/increased, weight decreased/increased
Uncommon (0.1% to 1%): Thirst
CardiovascularImmediate-release formulations:
Very common (10% or more): Tachycardia (up to 15.4%), chest pain (up to 10.6%)
Common (1% to 10%): Edema, hypotension, palpitations
Postmarketing reports: Peripheral edema
Extended-release tablets:
Common (1% to 10%): Chest pain, hot flush, palpitations
Uncommon (0.1% to 1%): Chest tightness, edema, hypotension, sinus tachycardia
Postmarketing reports: Peripheral edema
GenitourinaryImmediate-release formulations:
Very common (10% or more): Micturition difficulties (up to 12.2%), menstrual disorders (up to 10.4%)
Common (1% to 10%): Incontinence, sexual dysfunction
Frequency not reported: Menstrual irregularities, urinary retention
Postmarketing reports: Galactorrhea
Extended-release tablets:
Common (1% to 10%): Difficulty in micturition, dysmenorrhea, premenstrual syndrome, sexual dysfunction
Uncommon (0.1% to 1%): Urinary frequency, urinary incontinence
Postmarketing reports: Galactorrhea
DermatologicImmediate-release formulations:
Very common (10% or more): Sweating (up to 15.1%), rash (up to 11%)
Common (1% to 10%): Dermatitis
Frequency not reported: Pruritus
Postmarketing reports: Photosensitivity reaction, Stevens-Johnson syndrome
Extended-release tablets:
Common (1% to 10%): Pruritus, sweating increased
Uncommon (0.1% to 1%): Clamminess, rash, urticaria
Postmarketing reports: Stevens-Johnson syndrome
RespiratoryImmediate-release formulations:
Very common (10% or more): Nasal congestion (up to 17.4%)
Common (1% to 10%): Hyperventilation, upper respiratory tract infection
Extended-release tablets:
Common (1% to 10%): Allergic rhinitis, dyspnea, hyperventilation, nasal congestion, pharyngolaryngeal pain, upper respiratory tract infections
Uncommon (0.1% to 1%): Choking sensation, dysphonia, epistaxis, rhinorrhea, sleep apnea syndrome
OcularImmediate-release formulations:
Very common (10% or more): Blurred vision (up to 21%)
Rare (0.01% to 0.1%): Increased intraocular pressure
Frequency not reported: Diplopia
Extended-release tablets:
Common (1% to 10%): Blurred vision
Uncommon (0.1% to 1%): Mydriasis, photophobia
MusculoskeletalImmediate-release formulations:
Common (1% to 10%): Muscle stiffness, muscle tone disorders, muscular cramps, muscular twitching, rigidity
Uncommon (0.1% to 1%): Muscular weakness
Frequency not reported: Musculoskeletal weakness
Extended-release tablets:
Common (1% to 10%): Arthralgia, back pain, muscle cramps, muscle twitching, myalgia, pain in limb
Frequency not reported: Increased muscle spasticity
ImmunologicImmediate-release formulations:
Common (1% to 10%): Infection
Extended-release tablets:
Common (1% to 10%): Influenza
HypersensitivityImmediate-release formulations:
Common (1% to 10%): Allergy
Postmarketing reports: Angioedema
Extended-release tablets:
Postmarketing reports: Angioedema
HepaticImmediate-release formulations:
Rare (0.01% to 0.1%): Abnormal hepatic function tests, jaundice
Frequency not reported: Elevated bilirubin, elevated hepatic enzymes
Postmarketing reports: Hepatic failure, hepatitis
Extended-release tablets:
Postmarketing reports: Hepatic failure, hepatitis, liver enzyme elevations
EndocrineImmediate-release formulations:
Postmarketing reports: Gynecomastia, hyperprolactinemia
Extended-release tablets:
Postmarketing reports: Gynecomastia, hyperprolactinemia
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/3/2022.
Source: Drugs.com Alprazolam Xr (www.drugs.com/alprazolam.html).
August 31, 2020
July 13, 2022
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