Xanax side effects

xanax side effects


Generic name: alprazolam

Medically reviewed by Drugs.com. Last updated on Nov 15, 2021.

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

xanax side effects? In 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. See below for a comprehensive list of adverse effects.

For the Consumer

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


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. xanax side effects

Side effects requiring immediate medical attention

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


  • 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

Side effects not requiring immediate medical attention

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. xanax 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: xanax side effects

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


  • 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


Immediate-release formulations: The most commonly reported side effects included drowsiness/sedation, fatigue and tiredness, impaired coordination, memory impairment, and irritability. xanax side effects


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 disorderhypersomnialethargy, 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]


Immediate-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[Ref]


Immediate-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[Ref]


Immediate-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[Ref]


Immediate-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[Ref]


Immediate-release formulations:

Very common (10% or more): Tachycardia (up to 15.4%), chest pain (up to 10.6%)

Common (1% to 10%): Edemahypotensionpalpitations

Postmarketing reports: Peripheral edema


Extended-release tablets: xanax side effects

Common (1% to 10%): Chest pain, hot flush, palpitations

Uncommon (0.1% to 1%): Chest tightness, edema, hypotension, sinus tachycardia

Postmarketing reports: Peripheral edema[Ref]


Immediate-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: xanax side effects

Common (1% to 10%): Difficulty in micturition, dysmenorrhea, premenstrual syndrome, sexual dysfunction

Uncommon (0.1% to 1%): Urinary frequencyurinary incontinence

Postmarketing reports: Galactorrhea[Ref]


Immediate-release formulations: xanax side effects

Very common (10% or more): Sweating (up to 15.1%), rash (up to 11%)

Common (1% to 10%): Dermatitis

Frequency not reportedPruritus

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[Ref]


Immediate-release formulations: xanax side effects

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 rhinitisdyspnea, hyperventilation, nasal congestion, pharyngolaryngeal pain, upper respiratory tract infections

Uncommon (0.1% to 1%): Choking sensation, dysphonia, epistaxis, rhinorrhea, sleep apnea syndrome[Ref]


Immediate-release formulations: xanax side effects

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[Ref]


Immediate-release formulations: xanax side effects

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: xanax side effects

Common (1% to 10%): Arthralgia, back pain, muscle cramps, muscle twitching, myalgia, pain in limb

Frequency not reported: Increased muscle spasticity[Ref]


Immediate-release formulations: xanax side effects

Common (1% to 10%): Infection


Extended-release tablets:

Common (1% to 10%): Influenza[Ref]


Immediate-release formulations: xanax side effects

Common (1% to 10%): Allergy

Postmarketing reportsAngioedema


Extended-release tablets: xanax side effects

Postmarketing reports: Angioedema[Ref]


Immediate-release formulations: xanax side effects

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: xanax side effects

Postmarketing reports: Hepatic failure, hepatitis, liver enzyme elevations[Ref]


Immediate-release formulations:

Postmarketing reports: Gynecomastia, hyperprolactinemia


Extended-release tablets: xanax side effects

Postmarketing reports: Gynecomastia, hyperprolactinemia[Ref]

Frequently asked questions


1. “Product Information. Xanax (alprazolam).” Pharmacia and Upjohn, Kalamazoo, MI.

2. “Product Information. Niravam (alprazolam).” Schwarz Pharma, Mequon, WI.

3. “Product Information. Xanax XR (alprazolam).” Pfizer U.S. Pharmaceuticals Group, New York, NY.

4. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

5. Cerner Multum, Inc. “Australian Product Information.” O 0

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. xanax side effects

Some side effects may not be reported. You may report them to the FDA.


Xanax side effects

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