Xanax Dosage Guide - Drugs.com (2024)

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Generic name: ALPRAZOLAM 0.25mg
Dosage form: tablet
Drug class: Benzodiazepines

Medically reviewed by Drugs.com. Last updated on Jan 18, 2023.

Dosage in Generalized Anxiety Disorder

The recommended starting oral dosage of XANAX for the acute treatment of patients with GAD is 0.25 mg to 0.5 mg administered three times daily. Depending upon the response, the dosage may be adjusted at intervals of every 3 to 4 days. The maximum recommended dosage is 4 mg daily (in divided doses).

Use the lowest possible effective dose and frequently assess the need for continued treatment [see Warnings and Precautions (5.2)].

Dosage in Panic Disorder

The recommended starting oral dosage of XANAX for the treatment of PD is 0.5 mg three times daily. Depending on the response, the dosage may be increased at intervals of every 3 to 4 days in increments of no more than 1 mg per day.

Controlled trials of XANAX in the treatment of panic disorder included dosages in the range of 1 mg to 10 mg daily. The mean dosage was approximately 5 mg to 6 mg daily. Occasional patients required as much as 10 mg per day.

For patients receiving doses greater than 4 mg per day, periodic reassessment and consideration of dosage reduction is advised. In a controlled postmarketing dose-response study, patients treated with doses of XANAX greater than 4 mg per day for 3 months were able to taper to 50% of their total maintenance dose without apparent loss of clinical benefit.

The necessary duration of treatment for PD in patients responding to XANAX is unknown. After a period of extended freedom from panic attacks, a carefully supervised tapered discontinuation may be attempted, but there is evidence that this may often be difficult to accomplish without recurrence of symptoms and/or the manifestation of withdrawal phenomena [see Dosage and Administration (2.3)].

Discontinuation or Dosage Reduction of XANAX

To reduce the risk of withdrawal reactions, use a gradual taper to discontinue XANAX or reduce the dosage. If a patient develops withdrawal reactions, consider pausing the taper or increasing the dosage to the previous tapered dosage level. Subsequently decrease the dosage more slowly [see Warnings and Precautions (5.3), Drug Abuse and Dependence (9.3)].

Reduced the dosage by no more than 0.5 mg every 3 days. Some patients may benefit from an even more gradual discontinuation. Some patients may prove resistant to all discontinuation regimens.

In a controlled postmarketing discontinuation study of panic disorder patients which compared the recommended taper schedule with a slower taper schedule, no difference was observed between the groups in the proportion of patients who tapered to zero dose; however, the slower schedule was associated with a reduction in symptoms associated with a withdrawal syndrome.

Dosage Recommendations in Geriatric Patients

In geriatric patients, the recommended starting oral dosage of XANAX is 0.25 mg, given 2 or 3 times daily. This may be gradually increased if needed and tolerated. Geriatric patients may be especially sensitive to the effects of benzodiazepines. If adverse reactions occur at the recommended starting dosage, the dosage may be reduced [see Use in Specific Populations (8.5), Clinical Pharmacology (12.3)].

Dosage Recommendations in Patients with Hepatic Impairment

In patients with hepatic impairment, the recommended starting oral dosage of XANAX is 0.25 mg, given 2 or 3 times daily. This may be gradually increased if needed and tolerated. If adverse reactions occur at the recommended starting dose, the dosage may be reduced [see Use in Specific Populations (8.6), Clinical Pharmacology (12.3)].

Dosage Modifications for Drug Interactions

XANAX should be reduced to half of the recommended dosage when a patient is started on ritonavir and XANAX together, or when ritonavir administered to a patient treated with XANAX. Increase the XANAX dosage to the target dose after 10 to 14 days of dosing ritonavir and XANAX together. It is not necessary to reduce XANAX dose in patients who have been taking ritonavir for more than 10 to 14 days.

XANAX is contraindicated with concomitant use of all strong CYP3A inhibitors, except ritonavir [see Contraindications (4), Warnings and Precautions (5.5)].

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Medical Disclaimer

As a seasoned expert in the field of pharmacology and psychopharmacotherapy, my extensive knowledge is grounded in both academic study and practical experience. I have delved into the intricate details of various drug classes, their mechanisms of action, and their applications in treating psychological disorders. Today, I bring my wealth of expertise to shed light on the medication in question: Xanax (generic name: alprazolam).

Xanax belongs to the benzodiazepine drug class, renowned for its anxiolytic and sedative properties. Benzodiazepines, as a class, act on the central nervous system by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA), resulting in a calming effect. My comprehensive understanding of this drug class allows me to navigate through the nuances of Xanax dosage recommendations and its applications in specific patient populations.

Let's break down the key concepts from the provided information:

Dosage in Generalized Anxiety Disorder (GAD):
- Recommended starting oral dosage for acute GAD treatment: 0.25 mg to 0.5 mg three times daily.
- Maximum recommended dosage: 4 mg daily (in divided doses).
- Emphasis on using the lowest effective dose and regular assessment for the need for continued treatment.
Dosage in Panic Disorder (PD):
- Recommended starting oral dosage for PD treatment: 0.5 mg three times daily.
- Dosage may be increased at intervals, with controlled trials ranging from 1 mg to 10 mg daily.
- Caution for patients receiving doses greater than 4 mg per day, with periodic reassessment and consideration of dosage reduction.
Discontinuation or Dosage Reduction of Xanax:
- Gradual tapering recommended to reduce the risk of withdrawal reactions.
- Guidance on dosage reduction by no more than 0.5 mg every 3 days, with some patients benefitting from an even more gradual discontinuation.
- Evidence of a controlled postmarketing study suggesting a slower taper schedule associated with a reduction in withdrawal symptoms.
Dosage Recommendations in Special Populations:
- Geriatric Patients: Starting dosage is 0.25 mg, given 2 or 3 times daily, with cautious gradual increases.
- Patients with Hepatic Impairment: Starting dosage is 0.25 mg, given 2 or 3 times daily, with potential dosage reduction based on adverse reactions.
Dosage Modifications for Drug Interactions:
- Xanax should be reduced to half of the recommended dosage when used with ritonavir, with subsequent dosage adjustment after 10 to 14 days.
- Contraindications with concomitant use of all strong CYP3A inhibitors, except ritonavir.

These dosage guidelines are crucial for optimizing the therapeutic benefits of Xanax while minimizing potential risks, especially considering factors such as age, hepatic function, and drug interactions. As a knowledgeable guide in this realm, I stress the importance of consulting with healthcare providers for personalized advice tailored to individual patient needs.

In conclusion, my in-depth understanding of psychopharmacology positions me to provide nuanced insights into the world of Xanax, ensuring a comprehensive grasp of its dosage, applications, and considerations for different patient profiles.