Xanax Side Effects

Generic name: alprazolam

Medically reviewed by Drugs.com. Last updated on Oct 9, 2022.

• Note: This document contains side effect information about alprazolam. Some dosage forms listed on this page may not apply to the brand name Xanax.

Summary

Common side effects of Xanax include: ataxia, cognitive dysfunction, constipation, difficulty in micturition, drowsiness, dysarthria, fatigue, memory impairment, skin rash, weight gain, weight loss, anxiety, blurred vision, diarrhea, insomnia, decreased libido, increased appetite, and decreased appetite. Other side effects include: hypotension, sexual disorder, muscle twitching, and increased libido. Continue reading for a comprehensive list of adverse effects.

Applies to alprazolam: oral solution, oral tablet, oral tablet disintegrating, oral tablet extended release.

Warning

Oral route (Tablet; Tablet, Extended Release)

Risks from Concomitant Use with Opioids; Abuse, Misuse, and Addiction and Dependence and Withdrawal ReactionsConcomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients for signs and symptoms of respiratory depression and sedation.The use of benzodiazepines, including alprazolam, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes. Before prescribing alprazolam and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.The continued use of benzodiazepines, including alprazolam, may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. Abrupt discontinuation or rapid dosage reduction of alprazolam after continued use may precipitate acute withdrawal reactions, which can be life-threatening. To reduce the risk of withdrawal reactions, use a gradual taper to discontinue alprazolam or reduce the dosage.

Serious side effects of Xanax

Along with its needed effects, alprazolam (the active ingredient contained in Xanax) 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

• Being forgetful
• changes in patterns and rhythms of speech
• clumsiness or unsteadiness
• difficulty with coordination
• discouragement
• drowsiness
• feeling sad or empty
• irritability
• lack of appetite
• lightheadedness
• loss of interest or pleasure
• relaxed and calm
• shakiness and unsteady walk
• sleepiness
• slurred speech
• tiredness
• trouble concentrating
• trouble performing routine tasks
• trouble sleeping
• trouble speaking
• unsteadiness, trembling, or other problems with muscle control or coordination
• unusual tiredness or weakness

Less common

• Blurred vision
• body aches or pain
• burning, crawling, itching, numbness, prickling, “pins and needles, or tingling feelings
• changes in behavior
• chills
• clay-colored stools
• confusion about identity, place, and time
• cough
• dark urine
• decrease in frequency of urination
• decrease in urine volume
• diarrhea
• difficult or labored breathing
• difficulty in passing urine (dribbling)
• difficulty with concentration
• difficulty with moving
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• dry mouth
• ear congestion
• environment seems unreal
• fainting
• feeling of unreality
• feeling warm
• fever
• general feeling of discomfort or illness
• headache
• inability to move the eyes
• inability to sit still
• increased blinking or spasms of the eyelid
• irregular heartbeats
• itching or rash
• joint pain
• lack or loss of self-control
• loss of bladder control
• loss of coordination
• loss of memory
• loss of voice
• mood or mental changes
• muscle aches, cramps, pain, stiffness, or weakness
• nausea
• need to keep moving
• painful urination
• problems with memory
• restlessness
• runny or stuffy nose
• seeing, hearing, or feeling things that are not there
• seizures
• sense of detachment from self or body
• shaking
• shivering
• sneezing
• sore throat
• sticking out of the tongue
• stomach pain
• sweating
• swollen joints
• talkativeness
• tightness in the chest
• trouble with balance
• twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
• uncontrolled twisting movements of the neck, trunk, arms, or legs
• unpleasant breath odor
• unusual dullness or feeling of sluggishness
• unusual facial expressions
• unusually deep sleep
• unusually long duration of sleep
• vomiting of blood
• yellow eyes or skin

Rare

• Actions that are out of control
• attack, assault, or force
• chest pain
• continuing ringing or buzzing or other unexplained noise in the ears
• decreased awareness or responsiveness
• deep or fast breathing with dizziness
• ear pain
• false or unusual sense of well-being
• fast, irregular, pounding, or racing heartbeat or pulse
• feeling jittery
• feeling unusually cold
• generalized slowing of mental and physical activity
• hearing loss
• hoarseness
• lack of feeling or emotion
• loss of control of the legs
• loss of strength or energy
• nightmares
• numbness of the feet, hands, and around mouth
• severe sleepiness
• shakiness in the legs, arms, hands, or feet
• sleep talking
• swelling
• talking, feeling, and acting with excitement
• thoughts of killing oneself
• uncaring
• unusual weak feeling
• voice changes

Incidence not known

• Light-colored stools
• upper right abdominal or stomach pain

Get emergency help immediately if any of the following symptoms of overdose occur while taking alprazolam:

Symptoms of overdose

• Change in consciousness
• confusion
• lack of coordination
• loss of consciousness
• sleepiness or unusual drowsiness

Other side effects of Xanax

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

• Absent, missed, or irregular menstrual periods
• decreased appetite
• decreased interest in sexual intercourse
• decreased sexual performance or desire abnormal ejaculation
• difficulty having a bowel movement (stool)
• inability to have or keep an erection
• increased appetite
• increased in sexual ability, desire, drive, or performance
• increased interest in sexual intercourse
• increased weight
• loss in sexual ability, desire, drive, or performance
• stopping of menstrual bleeding
• watering of the mouth
• weight loss

Less common

• Blistering, crusting, irritation, itching, or reddening of the skin
• change in taste bad unusual or unpleasant (after) taste
• cracked, dry, or scaly skin
• double vision
• feeling of warmth
• heavy bleeding
• menstrual changes
• pelvic pain
• redness of the face, neck, arms, and occasionally, upper chest
• seeing double
• stomach bloating and cramping
• sudden sweating
• unexplained runny nose or sneezing

Rare

• Acid or sour stomach
• belching
• bigger, dilated, or enlarged pupils (black part of the eye)
• change in color vision
• difficulty seeing at night
• feeling of constant movement of self or surroundings
• feeling of relaxation
• heartburn
• hives or welts
• increased sensitivity of the eyes to sunlight
• indigestion
• redness of the skin
• sensation of spinning
• stomach discomfort or upset

Incidence not known

• Blistering, peeling, or loosening of the skin
• red, irritated eyes
• red skin lesions, often with a purple center
• sores, ulcers, or white spots in the mouth or on the lips
• swelling of the breasts or breast soreness in both females and males
• unexpected or excess milk flow from the breasts

For Healthcare Professionals

Applies to alprazolam: compounding powder, oral concentrate, oral solution, oral tablet, oral tablet disintegrating, oral tablet extended release.

General

Immediate-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.^[Ref]

Nervous system

Immediate-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^[Ref]

Xanax Side Effects

Generic name: alprazolam

Medically reviewed by Drugs.com. Last updated on Oct 9, 2022.

• Warning
• Serious side effects
• Other side effects
• Professional info
• FAQ

Note: This document contains side effect information about alprazolam. Some dosage forms listed on this page may not apply to the brand name Xanax.

Summary

Common side effects of Xanax include: ataxia, cognitive dysfunction, constipation, difficulty in micturition, drowsiness, dysarthria, fatigue, memory impairment, skin rash, weight gain, weight loss, anxiety, blurred vision, diarrhea, insomnia, decreased libido, increased appetite, and decreased appetite. Other side effects include: hypotension, sexual disorder, muscle twitching, and increased libido. Continue reading for a comprehensive list of adverse effects.

Applies to alprazolam: oral solution, oral tablet, oral tablet disintegrating, oral tablet extended release.

Warning

Oral route (Tablet; Tablet, Extended Release)

Risks from Concomitant Use with Opioids; Abuse, Misuse, and Addiction and Dependence and Withdrawal ReactionsConcomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients for signs and symptoms of respiratory depression and sedation.The use of benzodiazepines, including alprazolam, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes. Before prescribing alprazolam and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.The continued use of benzodiazepines, including alprazolam, may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. Abrupt discontinuation or rapid dosage reduction of alprazolam after continued use may precipitate acute withdrawal reactions, which can be life-threatening. To reduce the risk of withdrawal reactions, use a gradual taper to discontinue alprazolam or reduce the dosage.

Serious side effects of Xanax

Along with its needed effects, alprazolam (the active ingredient contained in Xanax) 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

• Being forgetful
• changes in patterns and rhythms of speech
• clumsiness or unsteadiness
• difficulty with coordination
• discouragement
• drowsiness
• feeling sad or empty
• irritability
• lack of appetite
• lightheadedness
• loss of interest or pleasure
• relaxed and calm
• shakiness and unsteady walk
• sleepiness
• slurred speech
• tiredness
• trouble concentrating
• trouble performing routine tasks
• trouble sleeping
• trouble speaking
• unsteadiness, trembling, or other problems with muscle control or coordination
• unusual tiredness or weakness

Less common

• Blurred vision
• body aches or pain
• burning, crawling, itching, numbness, prickling, “pins and needles, or tingling feelings
• changes in behavior
• chills
• clay-colored stools
• confusion about identity, place, and time
• cough
• dark urine
• decrease in frequency of urination
• decrease in urine volume
• diarrhea
• difficult or labored breathing
• difficulty in passing urine (dribbling)
• difficulty with concentration
• difficulty with moving
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• dry mouth
• ear congestion
• environment seems unreal
• fainting
• feeling of unreality
• feeling warm
• fever
• general feeling of discomfort or illness
• headache
• inability to move the eyes
• inability to sit still
• increased blinking or spasms of the eyelid
• irregular heartbeats
• itching or rash
• joint pain
• lack or loss of self-control
• loss of bladder control
• loss of coordination
• loss of memory
• loss of voice
• mood or mental changes
• muscle aches, cramps, pain, stiffness, or weakness
• nausea
• need to keep moving
• painful urination
• problems with memory
• restlessness
• runny or stuffy nose
• seeing, hearing, or feeling things that are not there
• seizures
• sense of detachment from self or body
• shaking
• shivering
• sneezing
• sore throat
• sticking out of the tongue
• stomach pain
• sweating
• swollen joints
• talkativeness
• tightness in the chest
• trouble with balance
• twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
• uncontrolled twisting movements of the neck, trunk, arms, or legs
• unpleasant breath odor
• unusual dullness or feeling of sluggishness
• unusual facial expressions
• unusually deep sleep
• unusually long duration of sleep
• vomiting of blood
• yellow eyes or skin

Rare

• Actions that are out of control
• attack, assault, or force
• chest pain
• continuing ringing or buzzing or other unexplained noise in the ears
• decreased awareness or responsiveness
• deep or fast breathing with dizziness
• ear pain
• false or unusual sense of well-being
• fast, irregular, pounding, or racing heartbeat or pulse
• feeling jittery
• feeling unusually cold
• generalized slowing of mental and physical activity
• hearing loss
• hoarseness
• lack of feeling or emotion
• loss of control of the legs
• loss of strength or energy
• nightmares
• numbness of the feet, hands, and around mouth
• severe sleepiness
• shakiness in the legs, arms, hands, or feet
• sleep talking
• swelling
• talking, feeling, and acting with excitement
• thoughts of killing oneself
• uncaring
• unusual weak feeling
• voice changes

Incidence not known

• Light-colored stools
• upper right abdominal or stomach pain

Get emergency help immediately if any of the following symptoms of overdose occur while taking alprazolam:

Symptoms of overdose

• Change in consciousness
• confusion
• lack of coordination
• loss of consciousness
• sleepiness or unusual drowsiness

Other side effects of Xanax

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

• Absent, missed, or irregular menstrual periods
• decreased appetite
• decreased interest in sexual intercourse
• decreased sexual performance or desire abnormal ejaculation
• difficulty having a bowel movement (stool)
• inability to have or keep an erection
• increased appetite
• increased in sexual ability, desire, drive, or performance
• increased interest in sexual intercourse
• increased weight
• loss in sexual ability, desire, drive, or performance
• stopping of menstrual bleeding
• watering of the mouth
• weight loss

Less common

• Blistering, crusting, irritation, itching, or reddening of the skin
• change in taste bad unusual or unpleasant (after) taste
• cracked, dry, or scaly skin
• double vision
• feeling of warmth
• heavy bleeding
• menstrual changes
• pelvic pain
• redness of the face, neck, arms, and occasionally, upper chest
• seeing double
• stomach bloating and cramping
• sudden sweating
• unexplained runny nose or sneezing

Rare

• Acid or sour stomach
• belching
• bigger, dilated, or enlarged pupils (black part of the eye)
• change in color vision
• difficulty seeing at night
• feeling of constant movement of self or surroundings
• feeling of relaxation
• heartburn
• hives or welts
• increased sensitivity of the eyes to sunlight
• indigestion
• redness of the skin
• sensation of spinning
• stomach discomfort or upset

Incidence not known

• Blistering, peeling, or loosening of the skin
• red, irritated eyes
• red skin lesions, often with a purple center
• sores, ulcers, or white spots in the mouth or on the lips
• swelling of the breasts or breast soreness in both females and males
• unexpected or excess milk flow from the breasts

For Healthcare Professionals

Applies to alprazolam: compounding powder, oral concentrate, oral solution, oral tablet, oral tablet disintegrating, oral tablet extended release.

General

Immediate-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.^[Ref]

Nervous system

Immediate-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^[