What is Xanax?
Xanax is an antianxiety medication in the benzodiazepine family. This is the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others. Xanax works by decreasing abnormal excitement in the brain. The Food and Drug Administration (FDA) approved it in October 1981.
Benzodiazepines act on the brain and central nervous system (CNS) to produce a calming effect. Xanax slows down the movement of brain chemicals that may have become unbalanced, resulting in a reduction in nervous tension and anxiety. Xanax works by boosting the effects of a natural chemical called gamma-aminobutyric acid, which is made in the brain.
In a meta-analysis of individuals using benzodiazepines on a long-term basis, cognitive impairments were noted despite stopping the benzodiazepines. These include problems with visuospation cognition, attention and concentrating, general intelligence, and psychomotor speed.
How Long Does It Take Your Body To Metabolize Xanax?
In comparison with other benzodiazepines, the body absorbs Xanax quickly, so its effects come on rapidly. Within about 1–2 hours, the concentration of Xanax in the blood reaches its peak. The effects of the drug usually appear within 1 hour, with one small-scale study finding an average onset time of 49 minutes with oral administration.
Xanax also leaves the body quickly. Its half-life is 11.2 hours in healthy adults, meaning that the body removes about half of the Xanax that it has absorbed in just over 11 hours. Doctors often prescribe Xanax to take three times per day, spread out over the course of treatment.
Where is Xanax Metabolized?
There are individual factors that determine how long, specifically, it would take someone to completely metabolize a dose of Xanax, and some of these primary individual indicators include liver and kidney function. Some individuals are rapid metabolizers, while others are classified as poor metabolizers, and Xanax is metabolized in the liver. The liver enzyme CYP3A4 is primarily responsible for metabolizing it.
For people who have problems with liver functionality, it can take longer to eliminate Xanax fully. If you have liver disease, Xanax is likely to stay in your system longer than someone with completely normal liver function.
There isn’t full evidence as to whether kidney function plays a role in the elimination of Xanax, but there is some belief in the medical community that impaired renal function could also slow down the clearance of Xanax from the system of the user. Other factors that could potentially impact how quickly Xanax is metabolized include a person’s basal metabolic rate, urinary pH, or body mass and height.
If you take other drugs that impact the function of certain liver enzymes, you may also see a slower rate of elimination if you were to take Xanax.
Some of the drugs that have been shown to reduce clearance time for Xanax include Ritonavir, SSRIs, and Cimetidine. If you take these and other drugs with a similar impact, it could lead to too much Xanax accumulating in your body, which could be a serious issue. There has even been some research showing oral contraceptives may play a role in how quickly the body can process and metabolize Xanax.
These are some of the reasons it’s so important to take Xanax only under the supervision of a physician, and exactly as instructed.
Substance Dependence
People who take benzodiazepines for an extended amount of time may build up a tolerance for some effects of the drugs. When tolerance occurs, your body requires a larger dose or an increased frequency of use to achieve the same or similar effect that the substance had on you when you began taking it.
If you continually use Xanax, especially in larger quantities, you may develop a physical dependency on the medication. When this happens, your body doesn’t function properly without it. Of note: It is possible for someone to become physically dependent on the drug even when used as prescribed.
You can experience withdrawal symptoms if you suddenly stop using Xanax or suddenly decrease your dose significantly. Some users may continue taking it to avoid the onset of these unpleasant, potentially life-threatening withdrawal symptoms. The dangers of withdrawal from benzodiazepines like Xanax means that a person should not stop taking them without consulting with a medical provider. If they are possibly dependent on the medication, they should be tapered off gradually. Many addiction treatment programs offer supervised medical detox to provide a safer experience as you end your Xanax use and begin your recovery.
Withdrawal symptoms, or continuing the drug to avoid or alleviate withdrawal symptoms, is one of many possible signs of a substance use disorder but it does not indicate that a person has a substance use disorder in and of itself. A substance use disorder is marked by using a substance in a problematic pattern that causes significant impairment or distress. Withdrawing from alprazolam is more difficult than withdrawing from other benzodiazepines, warns the Western Journal of Medicine. Because Xanax has such a powerful, rapid effect on the brain cells, withdrawal symptoms can be more severe. Heavy users may experience convulsions, seizures, or psychotic episodes if they try to quit too abruptly.
Fertility
When abused or misused, Xanax can cause permanent damage to a person’s reproductive system, making it nearly impossible to conceive. Commonly used benzodiazepines like alprazolam can affect fertility in a variety of ways.
Common effects of Xanax on fertility include:
- Loss of libido
- Erectile dysfunction
- Amenorrhea (absence of menstrual cycle)
- Heavy bleeding during menstruation
- Irregular ovulation cycles
- Irregular menstrual cycles
- Hormonal imbalances
- Xanax excretion while breastfeeding
The most common effect of Xanax on fertility is a decrease in sex drive. Because Xanax works on the central nervous system to suppress nerve activity, it can decrease libido, making it difficult for a man to get an erection. When this occurs, conceiving can be highly difficult or impossible. This can also cause problems within a relationship, which decreases the likelihood of a pregnancy. This decrease in libido can also cause erectile dysfunction in men. Men with an addiction to Xanax are more likely to suffer from infertility among a variety of other health conditions.
Other Effects of Xanax on the Body
Alprazolam may increase the risk of serious or life-threatening breathing problems, sedation, or coma if used along with certain medications. Tell your doctor if you are taking or plan to take certain opiate medications for cough such as codeine (in Triacin-C, in Tuzistra XR) or hydrocodone (in Anexsia, in Norco, in Zyfrel) or for pain such as codeine (in Fiorinal), fentanyl (Actiq, Duragesic, Subsys, others), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Astramorph, Duramorph PF, Kadian), oxycodone (in Oxycet, in Percocet, in Roxicet, others), and tramadol (Conzip, Ultram, in Ultracet). Your doctor may need to change the dosages of your medications and will monitor you carefully. If you take alprazolam with any of these medications and you develop any of the following symptoms, call your doctor immediately or seek emergency medical care immediately: unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness. Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own.
Drinking alcohol or using street drugs during your treatment with alprazolam also increases the risk that you will experience these serious, life-threatening side effects. Do not drink alcohol or use street drugs during your treatment.
