Blue Xanax

There is only one blue Xanax pill and its made by Pfizer. It is a 1 mg elliptical-shaped tablet, scored on the back for splitting them in half. They are only available by prescription and classified as benzodiazepines. Their nonproprietary name is alprazolam. According to the NIH, this medication is hazardous, especially if taken with alcohol or other drugs.

• Each real tablet has “1.0” embossed on the front and a crease on the back for ease of splitting in half.

It is elliptical pill, imprinted with 1.0. It is supplied by Pfizer U.S. Pharmaceuticals Group as an immediate release formulation which acts quickly and wears off quickly. 

1 mg extended release	1 mg blue pill

On the other hand, the extended-release tablets are called Alprazolam-XR, designed to deliver sustained therapeutic concentrations for 24 h after once-daily dosing. Plasma concentrations gradually decline as the time for the next dose approaches, but still remain above therapeutic minimum levels. The anti-panic efficacy appears to be comparable to the original formulation.

They are rapidly absorbed after oral administration with a peak plasma concentration at 1 to 2 hours. The bioavailability averages 80 to 100%. It is 80% bound to serum proteins, mainly albumin. It is metabolized in the liver. Its metabolites are filtered out by the kidneys and excreted in the urine. The mean plasma half-life is about 11.2 hours in healthy adults.

It is dangerous to purchase them on the Internet or outside the United States. The sale and distribution of medicines outside the U.S. does not comply with safe-use regulations of the Food and Drug Administration (FDA). These medications may contain dangerous ingredients, or may not be distributed by a licensed pharmacy.

It belongs to the class of benzodiazepines which are drugs that work in the central nervous system and are indicated for a variety of medical conditions. It acts on specific receptors in the brain, called gamma-aminobutyric acid-A (GABA-A) receptors by attaching to them and making the nerves in the brain less sensitive to stimulation, resulting in a calming effect.

They are the most commonly prescribed psychotropic medication in the United States. It is frequently prescribed to manage panic and anxiety disorders. It has also been subject to misuse for recreational purposes because of its disinhibition, euphoria, and anxiolytic effects. Most of the near-fatal cases due to poly drug use. 

It is used most commonly in:

• Anxiety disorders
• Panic disorders
• Seizures
• Insomnia
• Premenstrual syndrome
• Depression
• As a muscle relaxant
• Alcohol withdrawal

Side effects

Allergic reactions can cause hives, difficulty breathing, swelling of the face, lips, tongue, or throat. 

This medication can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury. 

Symptoms of overdose include:

• Change in consciousness
• Confusion
• Lack of coordination
• Loss of consciousness
• Sleepiness or unusual drowsiness.

In immediate-release formulations, the most reported side effects include: 

• Drowsiness/sedation 
• Fatigue and tiredness
• Impaired coordination
• Memory impairment
• Irritability

In extended-release tablets, the most reported side effects include: 

• Sedation 
• Tremor
• Headache 
• Insomnia
• Somnolence

Dependence

Benzodiazepines may produce emotional and/or physical dependence (addiction) even when used as recommended. Physical dependence may develop after 2 or more weeks of daily use. The risk of withdrawal reactions when stopping increases with prolonged use of the medication.

It is classified as a Schedule 4 controlled substance under the Controlled Substance Act (CSA).

Withdrawal

Some withdrawal symptoms may last up to 12 months or longer if the medicine is stopped suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin.

After stopping, medical help should be requested if the following symptoms are presented: 

• Unusual muscle movements
• Being more active or talkative
• Sudden and severe changes in mood or behavior
• Confusion
• Hallucinations
• Seizures
• Suicidal thoughts or actions

As a result of withdrawal danger, abrupt discontinuation of treatment should be avoided. In all patients, the dosage should undergo gradual reduction when discontinuing therapy or when decreasing the daily intake.

Overdose

In overdose cases, respiration, blood pressure, and pulse rate require monitoring since they could reduce drastically. Intravenous fluids are necessary, and it is important to maintain an adequate airway. Flumazenil, a benzodiazepine receptor antagonist, is indicated for the complete or partial reversal of the sedative effects of Benzodiazepines. It should be kept in mind that this drug is very dangerous if taken in overdose or in combination will Alcohol, Barbiturates, Opioids or other tranquilizer and recreational type of drugs.

Contraindications

There is positive evidence of human fetal risk in pregnancy, hence its use is not recommended if pregnant. It can be used in pregnancy only when no alternatives are available and the benefit outweighs the risk, especially during the first trimester. Its use may be associated with an increased risk of congenital malformations. There are no adequate studies for this drug in pregnant women to inform of a drug-related risk.

Use is not recommended during breastfeeding. A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.

Use is not recommended alongside with opioids, barbiturates, and alcohol. It increases the risk of abuse and withdrawal reactions. Concomitant use of Xanax and opioids may result in profound sedation, respiratory depression, coma, and death.