What Is Blue Xanax – Pill Identifier

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

Blue Xanax is a blue, elliptical, or oval pill, imprinted with XANAX 1.0 and identified as Xanax 1 mg. It is supplied by Pfizer U.S. Pharmaceuticals Group as an immediate release formulation which acts quickly and wears off quickly.  Its generic name is Alprazolam.

1 mg extended release Xanax	1 mg blue Xanax 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 of alprazolam-XR appears to be comparable to the original formulation of Xanax (Alprazolam).

Xanax 1.0 mg is rapidly absorbed after oral administration with a peak plasma concentration at 1 to 2 hours. The bioavailability of oral alprazolam averages 80 to 100%. It is 80% bound to serum proteins, mainly albumin. Xanax is metabolized in the liver. Its metabolites are filtered out by the kidneys and excreted in the urine. The mean plasma half-life of alprazolam is about 11.2 hours in healthy adults.

Xanax 1 mg is classified as a Schedule 4 controlled substance under the Controlled Substance Act (CSA).

It is dangerous to purchase Xanax 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.

The generic name of Xanax is Alprazolam and 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.

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

It is used most commonly in:

• Anxiety disorders- Generalized anxiety disorder
• Panic disorders- with or without agoraphobia
• Seizures

• Insomnia
• Premenstrual syndrome
• Depression
• As a muscle relaxant
• Alcohol withdrawal

Side effects

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

Xanax 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

Xanax is a safe and effective medication when used as directed. 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 Xanax therapy increases with prolonged use of the medication.

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 Xanax, 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 dosage. The suggested method is that the daily dosage reduction should be not more than 0.5 mg every three days. Some patients may require an even slower dosage reduction. In patients with long term, chronic Alprazolam use, one should switch to a longer-acting Benzodiazepine, such as Clonazepam or Diazepam and titrate down gradually. This would result in fewer withdrawal side effects.

Overdose

Generally, the dosages used to treat anxiety do not exceed 4 mg/day. For panic disorder, immediate-release tablets might be used in a daily dosage of 5-6 mg/day but must not exceed 10 mg/day. For extended-release tablets, the maximum daily dosage must not exceed 3-6 mg/day. For anxiety associated with depression, the daily dosage should not exceed 1-4 mg/day.

In Xanax 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.

Treatment of various conditions

Each XANAX Tablet, for oral administration, contains 0.25, 0.5, 1 or 2 mg of alprazolam. 2 mg XANAX Tablets are multi-scored and may be divided in four 0.5 mg pieces, depending on the treatment plan.

• 0.25 mg: white, oval, scored, imprinted “XANAX 0.25”
• 0.5 mg: peach, oval, scored, imprinted “XANAX 0.5”
• 1 mg: blue, oval, scored, imprinted “XANAX 1.0”
• 2 mg: white, oblong, multi-scored, imprinted “XANAX” on one side and “2” on the reverse side.

The use and dosage of various Xanax pills depend deeply on the indicated pathology, the condition of the patient and on the treatment plan. 

In Generalized Anxiety Disorder, the recommended starting oral dosage of XANAX for the acute treatment is 0.25 mg to 0.5 mg, administered three times daily. Depending upon the response, the dosage may be adjusted at intervals of every 3 to 4 days. The maximum recommended dosage is 4 mg daily (in divided doses). 

In Panic Disorder, the recommended starting oral dosage of XANAX is 0.5 mg three times daily. Depending on the response, the dosage may be increased at intervals of every 3 to 4 days no more than 1 mg per day. For patients receiving doses greater than 4 mg per day, periodic reassessment and consideration of dosage reduction is advised. The average dosage may be 5-6 mg/day and the maximum dosage which should not be exceeded is 10 mg/day. 

Xanax is also used to treat Anxiety in Depression and the total daily dosage should be around 1-4 mg, divided in 3 dosages every 8 hours.

The extended-release tablets (Xanax XR) are used frequently for both conditions and the tablets should not be chewed, crushed or split, but instead should be swallowed as a whole. The use of Xanax XR is important to reduce the risk of withdrawal syndrome and other withdrawal symptoms that might arise due to the lack of therapy consistence which is very common in these types of pathologies.

In Generalized Anxiety Disorder, the recommended starting oral dosage of XANAX XR is 0.5 mg to 1 mg once daily. Depending on the response, the dosage may be adjusted at intervals of every 3 to 4 days, incrementing it with no more than 1 mg daily.

In Panic Disorder, the recommended starting oral dosage of XANAX XR is 0.5 mg to 1 mg once a day. The dosage may be adjusted every 3-4 days by no more than 1 mg/day. The average dosage per day should be around 3-6 mg.

In geriatric patients (elderly), the recommended starting oral dosage of XANAX is 0.25 mg, given 2 or 3 times daily. This may be gradually increased in case of need and if the drug is well-tolerated.

To reduce the risk of withdrawal reactions, it should be used a gradual taper to discontinue XANAX or reduce the dosage. If a patient develops withdrawal reactions, it should be considered to pause the taper or to increase the dosage to the previous tapered dosage level. The dosage should be reduced by no more than 0.5 mg every 3 days. Some patients may benefit from an even more gradual discontinuation. Some patients may prove resistant to all discontinuation regimens.

Contraindications

There is positive evidence of human fetal risk during Xanax administration 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, misuse, addiction, dependence, and withdrawal reactions. Concomitant use of Xanax and Opioids may result in profound sedation, respiratory depression, coma, and death.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/

https://www.ncbi.nlm.nih.gov/books/NBK538165/#article-17404.s4

https://www.ncbi.nlm.nih.gov/books/NBK538165/#article-17404.s3

https://pubmed.ncbi.nlm.nih.gov/6141930/