Alprazolam

alprazolam is evaluated for the following indications with varying evidence strength: Panic disorder (evidence tier B), Generalized anxiety disorder (evidence tier C), Insomnia (evidence tier F). See the full indication matrix with dosing and citations above on this page.

Common side effects of alprazolam (≥ 1 in 100): Drowsiness, ataxia, Cognitive impairment, coordination disturbance, Headache, Dry mouth, Reduced libido. See the Safety section for uncommon and serious reactions.

FDA category D. FDA category D. Use in the third trimester causes neonatal withdrawal and 'floppy infant' syndrome. Contraindicated.

Passes into breast milk and can cause infant sedation. Not recommended during breastfeeding.

alprazolam is contraindicated in: Hypersensitivity to benzodiazepines; Acute closed-angle glaucoma; Myasthenia gravis; Severe respiratory failure, sleep apnoea syndrome; Severe hepatic impairment. Full list in the Safety section.

FDA black-box warning (2020): combining benzodiazepines with opioids significantly increases the risk of profound sedation, respiratory depression, coma, and death.