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Before taking alprazolam, tell your doctor if you are using any of the following drugs:

• birth control pills;

• cimetidine (Tagamet);

• diltiazem (Tiazac, Cartia, Cardizem);

• isoniazid (Nydrazid, Rifamate);

• propoxyphene (Darvon, Darvocet);

• seizure medication;

• antibiotics such as fluconazole (Diflucan), itraconazole (Sporanox) or ketoconazole (Nizoral); or

• antidepressants such as fluvoxamine (Luvox), desipramine (Norpramin), or imipramine (Janimine, Tofranil).

If you are using any of these drugs, you may not be able to use alprazolam, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect alprazolam. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• unusual risk-taking behavior, decreased inhibitions, no fear of danger;

• depressed mood, thoughts of suicide or hurting yourself;

• hyperactivity, agitation, hostility, hallucinations;

• feeling light-headed, fainting;

• seizure (convulsions);

• urinating less than usual or not at all;

• muscle twitching, tremor; or

• jaundice (yellowing of the skin or eyes).

Less serious side effects are more likely to occur, such as:

• drowsiness, dizziness, feeling irritable;

• amnesia or forgetfulness, trouble concentrating;

• sleep problems (insomnia);

• muscle weakness, lack of balance or coordination, slurred speech;

• blurred vision;

• nausea, vomiting, constipation, appetite or weight changes;

• dry or watery mouth, increased sweating; or

• loss of interest in sex.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.