Xanax is a brand-name oral tablet prescribed for anxiety disorders. Xanax contains the active ingredient alprazolam and may not be safe to take during pregnancy and breastfeeding.

Xanax also comes in a form called Xanax XR extended-release oral tablet. With Xanax XR, the drug releases slowly into the body over time. In this article, the term “Xanax” refers to both forms of the drug.

Keep reading for specific information about reproductive health and Xanax. For a comprehensive look at Xanax, see this article.

Boxed warnings

Xanax has boxed warnings about the risks of misuse and addiction, withdrawal, and severe harm or death if taken with opioids. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Risk of misuse and addiction: With misuse, a drug is taken in a way other than how a doctor prescribes it. This includes taking Xanax more often or in higher doses than prescribed. Misuse can increase the risk of addiction, which can lead to overdose and even death.

Before prescribing Xanax, your doctor will evaluate your risk of misuse and addiction to determine whether Xanax is right for you.

Risk of withdrawal: Xanax also has a risk of dependence and withdrawal. Withdrawal symptoms are uncomfortable side effects that can occur when you suddenly stop taking a drug your body is dependent on. Taking Xanax for a long time or at higher dosages than recommended increases the risk.

Symptoms of Xanax withdrawal may include tremors, irritability, and hallucinations. Some symptoms can last a long time (more than 12 months), and some can be life threatening, such as seizures.

Due to this risk, your doctor will prescribe the lowest dose possible to treat your condition. If you decide to discontinue treatment, they may slowly lower your dose over time. A gradual decrease helps reduce your risk of withdrawal symptoms. You can learn about Xanax’s recommended dosages in this article.

Risk of severe harm or death if taken with opioids: Taking Xanax with opioids can cause severe harm, including respiratory depression, extreme sleepiness, and coma. The combination of Xanax and an opioid also increases the risk of death compared with opioids alone. If you take an opioid, be sure to tell your doctor before starting Xanax.

If your doctor prescribes these drugs together, they’ll monitor you closely for changes in breathing and alertness. They may also reduce your opioid or Xanax dosage. You, your caregiver, or other people you live with should know the signs and symptoms of respiratory depression. These include slow, shallow breathing, confusion, and decreased responsiveness.

You or someone you’re with should call 911 or a local emergency number if you experience any symptoms of respiratory depression.

For more information on these warnings, talk with your doctor or view the Xanax prescribing information.

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If you can become pregnant, it’s important to consider whether Xanax is a safe choice for you.

It’s not clear whether Xanax can cause congenital anomalies or pregnancy loss when taken during pregnancy. (Congenital anomalies are commonly known as birth defects.)

However, if Xanax is taken in the third trimester (weeks 29 to 40) or during labor or delivery, it may cause harmful effects. The newborn may experience problems such as:

If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of taking Xanax.

Note: Xanax has a boxed warning about the risk of dependence and withdrawal. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warnings” at the beginning of this article.

Pregnancy exposure registry

If your doctor prescribes Xanax during pregnancy, they may want you to sign up with the pregnancy exposure registry for the drug.

This registry monitors the health of people who are pregnant and take Xanax, and their infants. It aims to help healthcare professionals find out about the safety of psychiatric medications such as Xanax during pregnancy. To find out more, talk with your doctor.

If you’re breastfeeding or planning to do so, it’s important to consider how Xanax may affect you and your child.

Breastfeeding is not recommended while taking Xanax.

Xanax passes into breast milk and may have harmful effects in a child who is breastfed. These effects may include excessive sleepiness and withdrawal symptoms. Symptoms can include irritability, sleeping problems, and vomiting. Diarrhea, muscle twitching, and tremors are also possible symptoms.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about other treatment options. If you’re prescribed Xanax, talk with your doctor about how to feed your child while taking the medication.

If you’re sexually active and you or your partner can become pregnant, be sure to talk with your doctor about your birth control options while taking Xanax.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.