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Drowsiness, dizziness, increased saliva production, or changes in sexual drive or ability may occur when taking this medication. These are generally mild side effects, but if they persist or worsen, it is advisable to consult your healthcare provider. To minimize dizziness or lightheadedness, make sure to rise slowly from sitting or lying positions.

While most people tolerate this medication well, there are some serious side effects that require immediate attention. These include mental or mood changes like hallucinations or thoughts of suicide, difficulty speaking, loss of coordination, trouble walking, and memory issues. If you experience any of these, contact your healthcare provider promptly.

In rare cases, very serious side effects like yellowing of the eyes or skin, or seizures, may occur. Seek medical assistance immediately if these symptoms develop. Additionally, though uncommon, some individuals may experience a severe allergic reaction. Look out for symptoms such as rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or difficulty breathing, and seek urgent medical care if they occur.

This summary does not cover all possible side effects. If you notice any other unusual symptoms, it is important to reach out to your healthcare provider.

Certain products can interact with this medication. These include kava and Sodium Oxybate. Some drugs can influence how your body processes alprazolam, potentially impacting its effectiveness. Examples of these drugs include adagrasib, azole antifungals like Itraconazole and Ketoconazole, Cimetidine, some antidepressants such as Fluoxetine, Fluvoxamine, and Nefazodone, protease inhibitors like indinavir, macrolide antibiotics such as Erythromycin, rifamycins like Rifabutin, St. John's wort, and seizure medications like Phenytoin.

There is an increased risk of serious side effects, such as slow or shallow breathing and severe drowsiness or dizziness, when alprazolam is taken with other substances that cause drowsiness or breathing difficulties. Inform your doctor or pharmacist if you use opioid pain or cough medications (like codeine or hydrocodone), alcohol, marijuana, sleep or anxiety medications (such as Diazepam, Lorazepam, or Zolpidem), muscle relaxants (such as Carisoprodol or Cyclobenzaprine), or antihistamines (like Cetirizine or diphenhydramine).

Always check the labels of all your medications, including those for allergies or coughs and colds, as they might contain ingredients that cause drowsiness. Consult your pharmacist on how to use these products safely.

Additionally, smoking cigarettes lowers the levels of this medication in your blood. Inform your doctor if you smoke or have recently quit smoking.