Xanax XR is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Alprazolam affects chemicals in the brain that may become unbalanced and cause anxiety.

Xanax XR is used to treat anxiety disorders, panic disorders, and anxiety caused by depression.

Xanax XR may also be used for other purposes not listed in this medication guide.

Do not use Xanax XR if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax). This medication can cause birth defects in an unborn baby. Do not use Xanax XR if you are pregnant.

Before taking Xanax XR, tell your doctor if you have any breathing problems, glaucoma, kidney or liver disease, or a history of depression, suicidal thoughts, or addiction to drugs or alcohol.

Do not drink alcohol while taking Xanax XR. This medication can increase the effects of alcohol. Xanax XR may be habit-forming and should be used only by the person it was prescribed for. Xanax XR should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Take Xanax XR exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Xanax XR may be habit-forming and should be used only by the person it was prescribed for. Xanax XR should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Do not crush, chew, or break a Xanax extended-release tablet. Swallow the tablet whole. It is specially made to release alprazolam slowly in the body. Breaking the tablet would cause too much alprazolam to be released at one time.

Contact your doctor if this medicine seems to stop working as well in treating your panic or anxiety symptoms.

Your symptoms may return when you stop using Xanax XR after using it over a long period of time. You may also have seizures or withdrawal symptoms when you stop using Xanax XR.

Withdrawal symptoms may include blurred vision, trouble concentrating, loss of appetite, diarrhea, muscle twitching, numbness or tingling, or increased sensations.

Do not stop using Xanax XR suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

To be sure this medication is helping your condition, your doctor will need to check your progress on a regular basis. Do not miss any scheduled visits to your doctor.

Store Xanax XR at room temperature away from moisture, heat, and light. Remove any cotton from the bottle of disintegrating tablets, and keep the bottle tightly closed.

Keep track of how many pills have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

Do not use Xanax XR if you have:

• narrow-angle glaucoma;

• if you are also taking itraconazole (Sporanox) or ketoconazole (Nizoral); or

• if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).

Before taking Xanax XR, tell your doctor if you are allergic to any drugs, or if you have:

• asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;

• glaucoma;

• kidney or liver disease (especially alcoholic liver disease);

• a history of depression or suicidal thoughts or behavior; or

• a history of drug or alcohol addiction.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

It is dangerous to try and purchase Xanax XR on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of alprazolam purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide

FDA pregnancy category D. Xanax XR can cause birth defects in an unborn baby. Do not use Xanax XR without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Alprazolam can pass into breast milk and may harm a nursing baby. Do not use Xanax XR without telling your doctor if you are breast-feeding a baby.

The sedative effects of Xanax XR may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking Xanax XR. Do not give this medication to anyone under 18 years old.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of Xanax XR can be fatal.

Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, loss of balance or coordination, feeling light-headed, fainting, and coma.

Do not drink alcohol while taking Xanax XR. This medication can increase the effects of alcohol. Xanax XR can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Grapefruit and grapefruit juice may interact with Xanax XR and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction to Xanax XR: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• unusual risk-taking behavior, decreased inhibitions, no fear of danger;

• depressed mood, thoughts of suicide or hurting yourself;

• hyperactivity, agitation, hostility, hallucinations;

• feeling light-headed, fainting;

• seizure (convulsions);

• urinating less than usual or not at all;

• muscle twitching, tremor; or

• jaundice (yellowing of the skin or eyes).

Less serious Xanax XR side effects may include:

• drowsiness, dizziness, feeling irritable;

• amnesia or forgetfulness, trouble concentrating;

• sleep problems (insomnia);

• muscle weakness, lack of balance or coordination, slurred speech;

• blurred vision;

• nausea, vomiting, constipation, appetite or weight changes;

• dry or watery mouth, increased sweating; or

• loss of interest in sex.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before using Xanax XR, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by Xanax XR.

Before taking Xanax XR, tell your doctor if you are using any of the following drugs:

• birth control pills;

• cimetidine (Tagamet);

• diltiazem (Tiazac, Cartia, Cardizem);

• isoniazid (IsonaRif, Rifamate);

• propoxyphene (Darvon, Darvocet);

• seizure medication;

• antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox) or ketoconazole (Nizoral); or

• antidepressants such as fluvoxamine (Luvox), desipramine (Norpramin), or imipramine (Janimine, Tofranil).

This list is not complete and there may be other drugs that can interact with Xanax XR. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.