Xanor is alprazolam, a Schedule 5 benzodiazepine in 0.25 mg, 0.5 mg and 1 mg tablets, plus a slow-release form. It is prescribed for short-term relief of severe anxiety and panic disorder. It works quickly, and it is among the most habit-forming medicines in ordinary prescribing.
What is Xanor?
The South African Medicine Price Registry lists Xanor as Schedule 5 tablets containing alprazolam:
| Product | Form | Strengths |
|---|---|---|
| Xanor | Tablet | 0.25 mg, 0.5 mg, 1 mg |
| Xanor SR | Slow-release tablet | 0.5 mg and higher |
Alprazolam is registered here under other names too, including Adco-Alzam. Being given one instead of another is ordinary substitution — but be careful not to end up with two brands of the same medicine, which is a genuine risk when prescriptions come from different sources.
Alprazolam is a benzodiazepine. It enhances the effect of GABA, the brain’s main inhibitory signal, producing reduced anxiety, muscle relaxation and sedation.
Two features shape everything about it:
It acts fast — onset within about 20 to 30 minutes. That is why it works so well for panic, and why it is so reinforcing.
The standard form is short-acting. The effect fades within hours, and as it does, rebound anxiety is common — often experienced as the original anxiety returning, prompting another dose. That cycle is how dependence develops, and it develops faster with alprazolam than with longer-acting benzodiazepines.
Xanor SR releases the dose more evenly over the day, which reduces the peaks and the between-dose rebound. That makes it somewhat easier to take on a stable schedule — it does not remove the dependence risk, and SR tablets must be swallowed whole, never crushed or split.
Alprazolam is widely regarded as having higher dependence potential and a harder withdrawal than most of its class. That is a reason to use it briefly and deliberately, not a reason to refuse it where genuinely indicated.
What is Xanor commonly used for?
- Panic disorder, including panic attacks — one of its main registered uses.
- Severe anxiety, short-term, where symptoms are disabling rather than everyday stress.
- Anxiety associated with depression, alongside an antidepressant rather than instead of one.
- Short-term situational anxiety, such as before a procedure.
- Bridging treatment while an antidepressant takes effect — SSRIs take four to six weeks and can transiently worsen anxiety at first.
It is not treatment for ongoing anxiety. Benzodiazepines lose effect over weeks as tolerance develops, and dependence follows. What works over time is an SSRI or SNRI and cognitive behavioural therapy — CBT has evidence at least as strong as medication for anxiety and panic, and its benefit persists after treatment ends, which medication’s does not.
Courses are meant to be short — typically two to four weeks including the taper.
The bridging role is the honest one. Alprazolam covering the first weeks of an SSRI, with a stopping plan, is good prescribing. Alprazolam continuing for months because nothing else was started is how people end up dependent on something that is no longer helping.
How Xanor fits into this medicine category
| Group | Examples | Role |
|---|---|---|
| Benzodiazepines | Alprazolam (Xanor), oxazepam, lorazepam, diazepam | Rapid short-term relief; dependence risk |
| SSRIs / SNRIs | Escitalopram, sertraline, venlafaxine | First-line long-term treatment for anxiety and panic |
| Tricyclics | Amitriptyline (Trepiline) | Depression, some anxiety and pain |
| Buspirone | Buspirone | Anxiety without benzodiazepine dependence; slower |
| Beta blockers | Propranolol | Physical symptoms — tremor, palpitations |
| Sleep agents | Zolpidem and related | Short-term insomnia |
| Psychological therapy | CBT | Durable benefit; first-line |
See the mental health and neurology medicines hub.
What to check before using Xanor
Do not drink alcohol with it. Alcohol and benzodiazepines both suppress breathing and consciousness, and together the effect is more than additive. The combination is a common cause of preventable deaths.
Tell your doctor or pharmacist if you:
- Take opioid painkillers — tramadol, codeine, morphine. Combining opioids with benzodiazepines significantly raises the risk of dangerously slowed breathing, and needs a deliberate prescribing decision.
- Take other sedating medicines — sleeping tablets, sedating antihistamines, some antipsychotics, muscle relaxants, gabapentin or pregabalin.
- Take ketoconazole, itraconazole, clarithromycin, erythromycin, some HIV medicines or fluoxetine, all of which raise alprazolam levels substantially.
- Have breathing problems, particularly sleep apnoea or severe COPD.
- Have myasthenia gravis or severe liver disease.
- Have a history of dependence on alcohol, benzodiazepines or other substances — the strongest predictor of trouble.
- Are pregnant, planning pregnancy or breastfeeding.
- Are older, where benzodiazepines substantially increase the risk of falls, fractures and confusion.
Do not drive or operate machinery until you know how it affects you. Swallow SR tablets whole.
Ask about a stopping plan at the first prescription — how long you will take it, and what happens next. That single question prevents most of the problems below.
Possible cautions and when to ask a pharmacist or doctor
Common effects are drowsiness, unsteadiness, confusion, dizziness, reduced concentration and memory problems. Less commonly some people experience agitation, irritability or aggression — more likely in older adults, and worth reporting.
Dependence and withdrawal are the defining risks. With regular use over weeks the body adapts: the same dose does less, and stopping causes withdrawal — rebound anxiety worse than the original, insomnia, tremor, sweating, palpitations, and in severe cases seizures.
Never stop alprazolam abruptly after regular use. If you have been taking it daily and want to come off it, ask your doctor to plan a gradual reduction — often by switching to a longer-acting benzodiazepine first, which makes tapering considerably easier. Stopping suddenly is genuinely dangerous.
Get emergency help for:
- Very slow or shallow breathing, extreme drowsiness or unresponsiveness — particularly with alcohol or an opioid.
- Seizures, especially after stopping or reducing.
- Severe confusion or agitation.
- Swelling of the face, lips or tongue, or difficulty breathing.
Contact your doctor if:
- Anxiety is not improving, or you feel you need more than prescribed.
- The course is nearing its end with no plan for what follows.
- You notice memory gaps or marked confusion.
- Mood worsens, or you have thoughts of self-harm.
- You have been on it longer than a few weeks.
- You are struggling to stop. This is common, it is not a failure of willpower, and there are established tapering approaches.
- You have two brands of alprazolam in the house — that is a duplication worth checking with a pharmacist.
Related medicine guides
Frequently asked questions
What is Xanor used for? Short-term relief of severe anxiety and panic disorder, and sometimes as a bridge while an antidepressant takes effect. It contains alprazolam.
What is Xanor SR? A slow-release form that releases the dose more evenly, reducing between-dose rebound. It must be swallowed whole, and it does not remove the dependence risk.
How quickly does it work? Within about 20 to 30 minutes, which is why it suits panic — and why it is so reinforcing.
Is it addictive? Yes, more so than most benzodiazepines. Dependence can develop within weeks, which is why courses are kept short.
Can I stop when I feel better? After a few days, usually yes. After regular use, no — ask your doctor to plan a gradual reduction. Stopping suddenly can cause severe withdrawal including seizures.
Can I drink alcohol on it? No. The combination dangerously suppresses breathing and consciousness.
Why does my anxiety return a few hours after a dose? The standard form is short-acting, and rebound anxiety as it wears off is common. Taking another dose to relieve it is how dependence builds.
What works for long-term anxiety? SSRIs or SNRIs, and cognitive behavioural therapy — CBT’s benefit persists after treatment ends, which medication’s does not.