This sheet talks about exposure to alprazolam in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is alprazolam?

Alprazolam is a medication that has been used to anxiety and panic disorder, including anxiety associated with depression. Alprazolam is sold under different brand names, such as Xanax®, Niravam®, or Gabazolamine-0.5®. Alprazolam is in a class of medications call benzodiazepines. MotherToBaby has a general fact sheet on benzodiazepines at https://mothertobaby.org/fact-sheets/benzodiazepines-pregnancy/pdf/. There is also a fact sheet on anxiety at https://mothertobaby.org/fact-sheets/anxiety/pdf/ and a fact sheet on depression at https://mothertobaby.org/fact-sheets/depression-pregnancy/pdf/.

I take alprazolam. Can it make it harder for me to get pregnant?

Alprazolam has not been studied to see if taking it could make it harder for a woman to get pregnant.

Should I stop taking alprazolam once I find out I’m pregnant?

Talk with your healthcare providers before making any changes to this medication. Changes to your alprazolam treatment should be done under the direction of your healthcare provider. If you take this medication on a regular basis and then suddenly stop taking it, you could have withdrawal symptoms. Some of the withdrawal symptoms reported with alprazolam have included seizures and rebound anxiety. Your healthcare providers can help you decide if the benefit of taking the medication outweighs any possible risk to your pregnancy.

Does taking alprazolam increase the chance for miscarriage?

Miscarriage can occur in any pregnancy. Studies have not been done to see if alprazolam could increase the chance for a miscarriage.

Does taking alprazolam increase the chance of having a baby with a birth defect?

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. Most studies on alprazolam use in the first trimester have not reported a greater chance for birth defects. One report that looked at prescription records to see if a woman filled a prescription for alprazolam during her pregnancy found a slightly higher chance for heart defects. However, this type of research cannot determine if the woman used the medication once the prescription was picked up and is unable to review other factors in the woman’s lifestyle or health that could be associated with these findings.

Could alprazolam cause other pregnancy complications?

There have been reports of neonatal abstinence syndrome (NAS). Please see the next paragraph on withdrawal / NAS below.

Will my baby have withdrawal (Neonatal Abstinence Syndrome) if I continue to take alprazolam?

Studies have reported a risk for neonatal abstinence syndrome (NAS) with some benzodiazepines. NAS is the term used to describe withdrawal symptoms in newborns from medication that a mother takes during pregnancy.

NAS symptoms that have been reported with long term use of alprazolam in pregnancy include difficulty breathing, poor feeding, and vomiting. Most often, symptoms of NAS start soon after birth and may last several days. Babies can be treated for withdrawal.

Will taking alprazolam during pregnancy affect my baby’s behavior or cause learning problems?

Alprazolam has not been studied to see if taking it during a pregnancy would affect the child’s behavior or development.

Can I breastfeed my baby if I take alprazolam?

Alprazolam has not been well studied for use while breastfeeding. Small amounts of alprazolam can get into breast milk. There have been reports of sleepiness (hard to wake, low energy) in nursing infants. There is also a report of withdrawal-like irritability in a nursing infant whose mother used alprazolam during pregnancy and while breastfeeding. If any of these symptoms are seen, discuss them with your child’s healthcare provider. You can also talk with your healthcare provider about the option of shorter acting benzodiazepines that might work to treat your medical condition while breastfeeding. Talk to your healthcare providers about all your breastfeeding questions.

If a man takes alprazolam, could it affect his fertility (ability to get partner pregnant) or increase the chance of birth defects? 

Alprazolam has not been studied for use in men who are trying to get a partner pregnant. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

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