Mental Health Home > Precautions and Warnings With Orally Disintegrating Alprazolam

For some people, orally disintegrating alprazolam can cause depression or suicidal thoughts. The medicine may also be dangerous in people who have severe lung disease. A few other precautions and warnings with orally disintegrating alprazolam include possible drug interactions, the safety of taking the drug while nursing or pregnant, and potential dangers for some people with certain medical conditions.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking orally disintegrating alprazolam (Niravam®) if you have:
  • A history of drug or alcohol abuse
  • Glaucoma
  • Kidney disease, such as kidney failure (renal failure)
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Depression or bipolar disorder
  • Lung disease or breathing problems
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Orally Disintegrating Alprazolam Precautions and Warnings

Some warnings and precautions to be aware of prior to taking orally disintegrating alprazolam include the following:
  • Orally disintegrating alprazolam can cause physical dependence, which could lead to serious withdrawal symptoms if you stop the medication abruptly. Doses above 4 mg a day and use for longer than 12 weeks may increase the risk for withdrawal symptoms. Do not stop taking this medication suddenly or decrease your dose without talking to your healthcare provider.
  • Orally disintegrating alprazolam is a controlled substance because it has a potential for abuse. As a controlled substance, there are special rules and regulations controlling its use. People who take higher doses, who use the medication for a longer period, or who have a history of alcohol or drug abuse have a higher risk of becoming addicted to orally disintegrating alprazolam.
Do not take the drug more frequently or at a higher dose than prescribed. Talk to your healthcare provider if you believe you are developing a problem with orally disintegrating alprazolam abuse.
  • Orally disintegrating alprazolam may affect your ability to perform complex tasks requiring mental and motor skills. Taking orally disintegrating alprazolam with alcohol or other medications that cause drowsiness can increase this effect (see Drug Interactions With Orally Disintegrating Alprazolam for more information). Do not perform activities requiring mental or motor concentration, such as driving a car or operating machinery, until you know how this medication affects you.
  • Make sure to tell your healthcare provider if you experience any changes in mood, including depression or an overly excited and elevated mood (termed "mania"). Also, talk to your healthcare provider if you have any thoughts of suicide or of harming yourself while taking this medicine. Based on your individual situation, your healthcare provider can determine if orally disintegrating alprazolam is the best medication for you.
  • Older adults may be more sensitive to the side effects of this medication, including drowsiness and coordination problems. Because of this, older adults who take orally disintegrating alprazolam may have an increased risk for falls. Older adults should be started on lower doses and maintained on the lowest dose that treats their symptoms (see Orally Disintegrating Alprazolam Dosage).
  • Orally disintegrating alprazolam may be dangerous in people with severe lung disease. Make sure to talk to your healthcare provider about any lung or breathing problems you have before taking this medication.
  • Make sure your healthcare provider knows if you have liver or kidney disease, as your body may handle orally disintegrating alprazolam differently than expected.
  • There have been reports of people experiencing unexpected reactions to orally disintegrating alprazolam that are the opposite of the usual effects. In these cases, people may become restless, agitated, aggressive, or irritable. They may also have difficulty sleeping or may experience hallucinations (seeing or hearing things that are not there).
Talk to your healthcare provider if you notice any of these problems while taking orally disintegrating alprazolam. People who have certain mental health conditions, a history of aggression, or alcohol or substance abuse problems may be at an increased risk for these reactions.
  • Orally disintegrating alprazolam is a pregnancy Category D medication. This means that the drug may cause harm to an unborn baby if it is used during pregnancy (see Niravam and Pregnancy for more information).
  • Orally disintegrating alprazolam passes through breast milk. Therefore, if you are breastfeeding or plan to start, talk with your healthcare provider before taking this drug (see Niravam and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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