By Kayla Hyland, DVM; Rania Gollakner, BS, DVM, MPH

What is alprazolam?

Alprazolam (brand names: Xanax®, Niravam®, Alprazolam Intensol®) is a sedative/tranquilizer used as an adjunctive therapy to treat anxiety or panic.

Its use in cats and dogs to treat anxiety or phobias is “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is alprazolam given?

Alprazolam is given by mouth in the form of a tablet or liquid solution. Give this medication 30 to 60 minutes before the triggering event, with or without food. If vomiting occurs when given on an empty stomach, give the next dose with food or a treat.

Monitor your pet for adverse effects the first time you administer this medication. This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember; however, if it is close to time for the next dose, skip the dose you missed, give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

The side effects of alprazolam include sedation, increased appetite, or uncoordinated walking. Learning may be affected and so this medication can impede training efforts. Healthy, non-geriatric, adult cats or dogs may exhibit opposite effects such as aggression, anxiety, excitement, or agitation. With long-term use, physical dependence is possible.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Alprazolam should not be used in pets that are allergic to it or pets that have a paradoxical reaction to the medication (opposite reaction than expected). Alprazolam should be used with caution in pets that are debilitated, geriatric, pregnant, lactating, or in pets with liver or kidney disease, or with glaucoma. It should be used cautiously in working animals, as this medication may affect their abilities.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with alprazolam: amiodarone, antacids, antihypertensive agents, azole antifungal agents (e.g., ketoconazole), carbonic anhydrase inhibitors, CNS depressant agents, digoxin, fluoxetine, fluvoxamine, hepatic enzyme inducers, hepatic enzyme inhibitors, ifosfamide, lithium, nondepolarizing neuromuscular blockers, phenobarbital, phenytoin, rifampin, theophylline/aminophylline, tricyclic antidepressants, valproic acid, divalproex, and yohimbine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring required, other than watching for adverse reactions while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. If using in cats long term, your veterinarian may monitor liver enzymes. In these cases, monitor your cat at home for yellowing of the skin, eyes, or gums, and contact your veterinarian if you notice these signs.

How do I store alprazolam?

Alprazolam should be stored at room temperature away from direct sunlight. Compounded liquid medications are usually stored in the refrigerator or at room temperature, away from light, but these recommendations can vary depending on the compounding pharmacy. Follow the directions provided on the label.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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