How Quickly Does Xanax Work?

Xanax shows an immediate effect to help alleviate the symptoms of anxiety and panic. It starts to kick in within an hour of taking the prescribed dose to give a calming effect. 

Xanax is the brand name of the active drug alprazolam. It is a Schedule IV controlled drug and has the potential for misuse. Xanax was initially approved by the Food and Drug Administration (FDA) for treating anxiety and panic disorder.

Anxiety is a mild or severe feeling of fear or worry. A panic attack occurs when the body experiences overwhelming fear, apprehension, and anxiety. This results in intense psychological (mental) and physical symptoms.

Xanax belongs to the class of drugs called benzodiazepines (BZDs). BZDs decrease excitement in the brain. They are among the most widely prescribed medications in the United States.

This article highlights the mechanism of action, the time it takes to work, and other important information on using Xanax safely. 

How Quickly Does Xanax Work?

Xanax starts to kick in within an hour or two after taking an initial dose. It is quickly absorbed by the body to produce a sedative and relaxing effect.

However, many other factors could affect how long Xanax kicks in. It may differ depending on the following:

• Your body's metabolism
• Age
• Height
• Weight
• Gender
• Health conditions, like kidney and liver function
  

Xanax tablets are available in dosage forms of 0.25, 0.5, 1.0, and 2.0 milligrams (mg).

General dosage regimens of Xanax include the following:

Generalized Anxiety Disorder

• The recommended initial oral dose of Xanax for the acute treatment of generalized anxiety disorder is 0.25 milligrams to 0.5 milligrams, three times a day.
• A dose adjustment may be required depending on the individual response.
• Your healthcare provider will increase the dose at intervals every three to four days, as required. Depending upon the response. 
• The maximum recommended dosage is 4 milligrams daily (in divided doses).

Panic disorder

• The initial oral dosage of Xanax for the treatment of panic disorder is 0.5 milligrams three times daily. 
• Your healthcare provider may increase every three to four days in increments of no more than 1 milligram daily.
  

Discontinuation or Dose Reduction

• Don't stop Xanax without asking your healthcare provider, as it may result in a severe risk of withdrawal reactions. 
• Your healthcare provider will gradually taper the dose to discontinue Xanax or reduce its dosage.
• If someone develops withdrawal reactions, immediately call your healthcare provider to consider pausing the taper or increasing and decreasing the dosage more slowly. 
• Reduce the dose not more than 0.5 milligrams every three days. 
  

Dosage Recommendations in People Over 65 Years

• In older adults, the recommended starting oral dosage of Xanax is 0.25 milligrams, given two or three times a day.
• Some older people may be susceptible to the effects of Xanax. Your healthcare provider may increase or decrease the dose as required. 

Dosage Recommendations in People with Liver Conditions

• The recommended starting oral dosage of Xanax is 0.25 milligrams, two or three times daily in people with liver conditions. 
• Your healthcare provider will prescribe the best suitable dose for you or discuss alternatives.  
  

Dosage Modifications for Drug Interactions

• In people using Xanax and ritonavir together, the dose of Xanax should be reduced to half of the recommended dosage. 
• Increase the Xanax dosage to the target after 10 to 14 days of taking ritonavir and Xanax together. 
• It is not necessary to reduce the Xanax dose in people who have been taking ritonavir for more than 10 to 14 days.
  

How Long Does Xanax Last?

Xanax reaches its peak concentration in your body one to two hours after taking it. This means it starts working within an hour after taking the first dose. 

The mean plasma elimination half-life is the time half of the drug concentration takes to eliminate from the body. Xanax's half-life is about 11.2 hours (range: 6.3 to 26.9 hours) in healthy adults. It is metabolized in the liver.

Xanax dissolves quickly in the body. It also works for a shorter amount of time than other benzodiazepines.

These properties have led to abuse in young people using Xanax for recreational purposes. 

Storage

Store Xanax tablets in the tightly closed container they came in. Store away from heat, direct light, and areas susceptible to high moisture levels (e.g., the bathroom).

Keep all the medicines locked out of sight and reach of children and pets, preferably in a locked cabinet.

Ask your local pharmacist for more information about properly discarding unwanted medication.

How Does Xanax Work?

Xanax (alprazolam) belongs to a class of psychoactive medications called benzodiazepines. 

Benzodiazepines, including Xanax, bind to the gamma-aminobutyric acid (GABA) receptors in the central nervous system (brain and nerves).

This increases GABA levels which help to alleviate anxiety and panic disorder symptoms.

When to Use Xanax

The FDA approved Xanax for use in adults for the following conditions:

• Acute treatment of generalized anxiety disorder (GAD) in adults.
• Anxiety associated with depression.
• Treatment of panic disorder (PD), with or without agoraphobia (extreme fear or irritation).

Xanax is also prescribed off-label for the treatment of other conditions, such as:

• Insomnia
• Depression
• Premenstrual syndrome

Who Shouldn't Take Xanax?

Xanax is unsafe for some people due to the risk of severe adverse effects.

It is contraindicated (not safe to use) in the following conditions.

• Hypersensitivity to Xanax or other benzodiazepines.
• When taking strong cytochrome P450 3A (CYP3A) inhibitor drugs such as ketoconazole or itraconazole. You can take ritonavir with Xanax as prescribed by your healthcare provider.
• During late pregnancy in pregnant people, Xanax may cause sedation and withdrawal symptoms in children exposed to it in utero. 
• Breastfeeding
• Pediatrics (children under the age of 18 years)

Side Effects and Safety

Benzodiazepines like Xanax come with a boxed warning by the FDA. It should only be used as prescribed by your healthcare provider. Benzodiazepines can cause a variety of side effects when used inappropriately.

Common Side Effects

Some common side effects of Xanax include the following:

• Changes in appetite
• Changes in sex drive or ability
• Constipation
• Difficulty concentrating
• Difficulty urinating
• Dizziness
• Drowsiness
• Dry mouth
• Headache
• Increased salivation
• Irritability
• Joint pain
• Light-headedness
• Nausea
• Talkativeness
• Tiredness
• Weight changes

Severe Side Effects

Some side effects of Xanax are severe and need medical help.

Contact your healthcare provider if you have any of the following problems:

• Confusion
• Problems with speech
• Problems with coordination or balance
• Seizures
• Severe skin rash
• Shortness of breath
• Yellowing of the skin or eyes

Warnings and Precautions

The use of Xanax needs close monitoring to avoid any potential adverse effects in certain conditions.

To ensure safe usage, closely monitor the use in the following conditions and take precautions if needed.

• Using Xanax exposes users to abuse, misuse, and addiction risks. This can lead to a risk of overdose or death. Closely monitor for these factors. Take immediate medical help if needed.
• Xanax is a CNS depressant. Caution is advised while driving a vehicle or operating machinery when using it. 
• Benzodiazepines like Xanax may worsen depression which may lead to suicidal thoughts. Appropriate prescription size and advanced monitoring for suicidal ideation should be considered in people with depression.
• Hypomania and mania have been reported in people with depression using Xanax.
• Monitor neonates exposed to Xanax during pregnancy or labor for signs of sedation. Give required medical treatment as needed.
• People with severe pulmonary disease are at risk. Closely monitor people with impaired respiratory function for signs and symptoms of respiratory depression, such as hypoventilation (shallow breathing) or apnea (sleep disorder) occur. Discontinue Xanax if needed.
  

Xanax Interactions

Xanax may interact with certain other medications and cause interactions. Consult your healthcare provider before taking any drug while using Xanax.

Some major drugs classes that interact with Xanax include the following:

Opioids

Use of benzodiazepines like Xanax and opioids increases the risk of respiratory depression. Closely monitor for respiratory depression and sedation. 

Examples of opioids include the following:

• MS Contin (morphine)
• Buprenorphine
• Hydromorphone
• Oxymorphone
• Oxycodone
• Actiq (fentanyl)
• Methadose (methadone)
• Codeine
• Dihydrocodeine
• Demerol (meperidine)
• Conzip (tramadol)
  

CNS Depressants

Xanax produces additive CNS depressant effects when used with other CNS depressants.

Examples of psychotropic medications include the following:

• Anticonvulsants
• Antihistamines
• Ethanol
• Other drugs that produce CNS depression
  

CYP3A Inhibitors

Using Xanax with potent CYP3A inhibitors is not advised, except with ritonavir.

CYP3A inhibitors affect medication clearance from the body. This can increase Xanax concentrations which can, in turn, increase the risk of adverse reactions.

Examples of CYP3A inhibitors include the following:

• Ketoconazole
• Sporanox (itraconazole)
• Nefazodone
• Luvox (fluvoxamine)
• Tagamet (cimetidine)
• Erythromycin
  

Ritonavir

Reduce Xanax dosage when ritonavir and Xanax are taken together. Using Xanax with a strong CYP3A inhibitor, except ritonavir, is contraindicated.

CYP3A Inducers

Concomitant use of CYP3A inducers can increase Xanax metabolism. This can decrease Xanax levels in the body.

Examples include the following:

• Tegretol (carbamazepine)
• Phenytoin
  

Digoxin

When using digoxin and Xanax, digoxin levels and toxicity need to be monitored frequently. Reduce the digoxin dose if necessary.

Other Considerations

Consider the following when taking Xanax:

• Avoid alcohol when taking Xanax. Alcohol can increase Xanax's CNS depressant effects.
• Avoid grapefruit products.
• Limit your caffeine intake.
• Take Xanax with or without food.
  

Summary

Xanax is a benzodiazepine drug used to treat panic disorder and anxiety symptoms.

Xanax is an immediate-acting drug and takes only nearly an hour to start working. It absorbs better than other benzodiazepines and works in a relatively lower time. This property of Xanax could also lead to its abuse.

Xanax has some side effects and is contraindicated in different situations. These include pregnancy and breastfeeding. Combining Xanax with other substances, such as alcohol or opioids, can be life-threatening.

Always use Xanax as your healthcare provider prescribes. Do not share this medicine with anyone.

When stopping Xanax, your healthcare provider will gradually decrease the dose. This helps to avoid withdrawal symptoms. Don't suddenly stop taking Xanax, even if you feel well.