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Alprazolam (Xanax)

Benzodiazepineprescriptionoral · inferred

Intermediate-acting benzodiazepine (GABA-A positive allosteric modulator) for panic disorder and generalized anxiety. Rapid onset of action. Metabolized by CYP3A4 to alpha-hydroxyalprazolam. High dependence potential; withdrawal can be severe. Available as immediate-release and XR formulations.

Projected serum levels — 0.50 mg, twice daily

Alprazolam (Xanax)
Alprazolam (Xanax) modeled serum levels, 0.50 mg twice daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 2 days. 0 0.25 0.50 0.75 1 Day 0 Day 4 Day 7 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 2
Alprazolam (Xanax) modeled serum levels with a loading dose of 0.97 mg, then 0.50 mg twice daily The first dose is larger so levels approach steady state faster. 0 0.25 0.50 0.75 1 Day 0 Day 4 Day 7 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 0.50 mg twice daily (oral).

Loading schedule: 0.97 mg on day 1, then 0.50 mg twice daily — reaching therapeutic levels sooner.

Modeled steady state after ~2 days: peak ≈ 0.78 mg, trough ≈ 0.41 mg body load. Population-based estimate over 15 days for a 0.50 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Benzodiazepine
Route modeled
Oral
Model confidence
inferred
Half-life
11 h
Common dose
0.50 mg
Suggested maximum
4 mg/day
Reference dose range
0.13–4 mg (single dose)
Suggested cadence
twice daily
Validated against
1 mg oral — Cmax 0.013 mg/L at 1.5 h

Documented interactions

  • contraindicated
    Carbamazepine (Tegretol) + Alprazolam (Xanax) CYP induction

    Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~0.20x

  • contraindicated
    Clarithromycin (Biaxin) + Alprazolam (Xanax) CYP inhibition

    Clarithromycin (Biaxin) mechanism_based of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~10.00x

  • contraindicated
    Dasatinib (Sprycel) + Alprazolam (Xanax) CYP inhibition

    Dasatinib (Sprycel) time_dependent_inhibitor of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~5.00x

  • contraindicated
    Diltiazem + Alprazolam (Xanax) CYP inhibition

    Diltiazem mechanism_based of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~10.00x

  • contraindicated
    Efavirenz (Sustiva) + Alprazolam (Xanax) CYP induction

    Efavirenz (Sustiva) inducer of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~0.12x

  • contraindicated
    Grapefruit (whole fruit) + Alprazolam (Xanax) CYP inhibition

    Grapefruit (whole fruit) mechanism_based of CYP3A4 predicted to change Alprazolam (Xanax) AUC by ~10.00x

Serum checks 66 modeled interaction pairings for alprazolam (xanax) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. I. Efficacy in short-term treatment Ballenger JC et al. · Archives of General Psychiatry, 1988 DOI

    Large multicenter RCT (526 patients) establishing alprazolam efficacy for panic disorder, with significant reductions in panic attacks, phobic avoidance, and anxiety compared to placebo.

  2. Alprazolam in the treatment of generalized anxiety and panic disorders: a double-blind placebo-controlled study Chouinard G et al. · Psychopharmacology, 1982 DOI

    Eight-week double-blind RCT of 50 outpatients showing alprazolam (0.25-3 mg/day) was significantly superior to placebo for both generalized anxiety and panic disorder symptoms.

  3. Clinical pharmacokinetics of alprazolam: therapeutic implications Greenblatt DJ, Wright CE · Clinical Pharmacokinetics, 1993 DOI

    Definitive PK review establishing alprazolam mean half-life of 11.2 hours, CYP3A4 metabolism, 80% protein binding, and prolonged half-life in elderly and hepatic impairment.

  4. Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis De Crescenzo F et al. · Lancet, 2022 DOI

    Network meta-analysis of 154 trials found benzodiazepines including alprazolam effective short-term but with unfavourable long-term tolerability; most had insufficient long-term data beyond 4 weeks.

5 published studies referenced in the app, each with a plain-language summary.