Xanax Dosage Instructions

Xanax Dosage Instructions

The recommended dosage of alprazolam tends to vary from one patient to another. The following table includes average doses for the use of this anti-anxiety medication:

Condition Age group Xanax Dosage
Anxiety - anxiety disorders like generalised anxiety disorder and acute episodes of anxiety. Adults Start with 0.25-0.5 mg, three times a day.
Older adults Start with 0.25 mg, two or three times a day.
Panic disorder which involves intense episodes of anxiety. Adults At the beginning of treatment, take 0.5 mg to 1 mg, once in the morning.
Older adults At the beginning of treatment, take 0.5 mg, once in the morning.
  • The maximum recommended dose for generalised anxiety disorder is 4 mg per day.
  • The maximum recommended dose for panic disorder is 10 mg per day. However, this high dose is very seldomly advised and the usual maintenance dose for panic disorder is 3-6 mg per day.
  • If you miss a dose, take it as soon as you remember. However, if it is nearly time for the next scheduled dose, just skip the forgotten dose and resume your regular dosing schedule.

How Long Does Xanax Last?

The effects of this medication are relatively brief so patients with anxiety disorders or panic attacks are generally advised to administer a dose three times a day. Most often, the strongest effects of the medication can be felt for 1 to 5 hours after administration. Residual effects such as sedation and sleepiness may extend for longer periods of time, depending on various factors such as the Xanax dosage and the individual patient.

How Long Does Xanax Stay in Your System?

Like most medications, the active ingredient in this sedative stays in the body for quite some time after the effects wear off. Scientists estimate the half-life of this medication is approximately 11.2 hours in healthy adults.

The half-life of a treatment is the length of time it takes for the body to eliminate 50% of the medication. This can, however, vary from person to person as it depends on several factors which include:

  • Weight - this medication stays in the body longer in people who weigh more because a larger weight makes it more difficult for the body to break down and absorb the medication. On average, the half-life of this medication increases to 21.8 hours for overweight or obsess people.
  • Age - this medication takes longer to be eliminated from the body among elderly people. The average half-life for geriatric patients is 16.3 hours.
  • Dosage - it generally takes longer for the body to metabolise larger doses of this medication so the higher the dose, the longer it will stay in your system.
  • Duration of treatment - if you have been taking this medication on a regular basis and for a long period of time, it will take longer to be removed. The reason for this is that there will be a higher concentration of the medication in your bloodstream.
  • Metabolism - people who are physically fit or have a fast metabolism tend to remove this medication faster from the body than those who live a more sedentary lifestyle.
  • Liver function - this medication stays in the body longer for people with reduced liver function. On average, the half-life for people with alcoholic liver disease is 19.7 hours.
  • Smoking - the half-life of this medication is decreased by up to 50% among smokers compared to people who do not smoke.
  • Alcohol - the consumption of alcohol increases the half-life of this medication so it will stay in the system for longer if it is taken with alcohol. Using this medication with alcohol is not recommended as it can significantly increase the risk of side effects.
  • Other interacting medications - a Xanax dosage stays in the system longer when this medication is taken with other medications that inhibit a certain enzyme called CYP3A4. These medications include ketaconazole, nefazodone and oral contraceptives.

On average, it takes 2 to 4 days for alprazolam to be completely eliminated from the body. However, in some people with the abovementioned conditions, this medication can take nearly 6 days for it to be entirely removed from the body.

Xanax Withdrawal Symptoms

Xanax Withdrawal Symptoms

This medication carries the same risk of withdrawal symptoms as other benzodiazepines. Long-term use of benzodiazepine medications can lead to physical and psychological dependence, particularly if high doses have been used.

If this medication has been used for a relatively long period of time, withdrawal symptoms may happen if treatment is discontinued abruptly. These symptoms include the following:

  • Anxiety, tension or restlessness
  • Confusion
  • Irritability
  • Headaches and muscle pain
  • Sleeping difficulties

In severe but extremely rare cases, derealisation, depersonalisation and hypersensitivity to light and sound may happen. Another uncommon withdrawal symptom that might happen to a small percentage of people is rebound insomnia. This is a short-term condition that happens when the symptoms that led a patient to be treated with this medication reoccur in an enhanced form.

If a tolerance to this medication is developed over a long-term period, it may lead to rebound insomnia. Various effects may accompany this condition including mood changes, anxiety and restlessness. The risk of experiencing withdrawal symptoms or rebound insomnia can be significantly decreased if you gradually reduce the dose at the end of treatment instead of ending it abruptly.

How to Come Off Xanax Safely

The active ingredient in this anxiety medication suppresses the central nervous system and enhances certain chemicals to reduce anxiety and promote sleep. Therefore, if this medication has been used on a long-term basis, it may take some time for the central nervous system to restore its natural balance of neurotransmitters.

To come off alprazolam safely, the Xanax dosage should be reduced slowly. The manufacturer of this medication recommends that patients do not exceed 0.5 mg every 3 days when tapering the dose at the end of treatment. For example, if you have been taking 2 mg per day in divided doses, the gradual tapering process should be as follows:

  • The decision is made to discontinue your Xanax dosage schedule on day 1.
  • On day 4, the dose should be reduced to 1.5 mg, in divided doses.
  • On day 7, the dose should be reduced to 1 mg, in divided doses.
  • On day 10, the dose should be 0.5 mg per day and treatment can be gradually ended by day 13.

Updated: 23rd January 2021
Review Due: January 2022



Fueled with a passion to try and help people less fortunate than himself Steve immersed himself in the medical industry. By researching new and innovative medical advancements and regularly sharing important information on social media Steve intends to make a difference where it matters most, people's health. His wealth of knowledge and keen eye for detail will help keep our readers informed and contribute towards improved health.

Tracy White – Mar 05, 2021
Hi Steve, I suffer from panic disorders and found this article very helpful. The level of detail that you provide is quite stunning and gave me both the confidence and knowledge needed to manage my condition better. Thank you - Tracy White

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