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Midazolam vs. Xanax

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Midazolam (Seizalam, Versed) and Alprazolam (Xanax) are both benzodiazepines, but they are used for different purposes. Midazolam is primarily used for sedation before surgeries and to treat long-lasting seizures, and it is available as an injection, oral syrup, and nasal solution. It is typically administered by a healthcare provider in a monitored setting. Alprazolam, on the other hand, is used to treat generalized anxiety disorder (GAD) and panic attacks and is taken orally, usually three times a day. While both medications can cause drowsiness and memory problems, midazolam is more likely to be used in a hospital setting due to its risk of severe breathing problems. Alprazolam has a higher risk of dependence and withdrawal symptoms, making it suitable only for short-term use. Additionally, midazolam is not safe to use late in pregnancy, whereas alprazolam should be avoided during pregnancy due to potential harm to the baby.

Midazolam

 

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Alprazolam

(Xanax)

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Summary for Midazolam

Prescription only

Midazolam is used for sedation before surgery and other medical procedures in children and adults, as well as treatment for status epilepticus (long-lasting seizures) in adults. It comes as an injection and oral syrup. The medication is typically given by a healthcare provider in a monitored setting and can't be used at home. Some side effects of midazolam include nausea, agitation, drowsiness, and pain at the injection site for the injection form. And although the brand name Versed has been discontinued, there are many generics still available.

Indications for Midazolam

  • Sedation for surgery or other medical procedure
  • Long-lasting seizure (status epilepticus) - Seizalam

Pros and Cons for Midazolam

Pros

  • Works within minutes to help you relax and feel calm before a medical procedure
  • Available as an injection and an oral syrup
  • Can be used in young children for sedation before a procedure

Cons

  • Risk of severe breathing problems so it should only be used in a healthcare facility
  • Can cause hangover effect and raise the risk of falls
  • Not safe to use late in pregnancy

Common Side Effects for Midazolam

Oral syrup

  • Vomiting (8%)
  • Nausea (4%)

Injection for sedation

  • Pain at injection site (4-5%)
  • Hiccups (4%)
  • Nausea (3%)
  • Vomiting (3%)

Injection for long-lasting seizure

  • Upper airway blockage (5%)
  • Agitation (4%)
  • Fever (4%)
  • Confusion (3%)

Warnings for Midazolam

  • Severe difficulty breathing
  • Continued memory problems after procedure
  • Harm to unborn baby if used in late pregnancy
  • Worsening of glaucoma

Summary for Xanax

Prescription only

Alprazolam (Xanax) is a benzodiazepine. It's approved to treat generalized anxiety disorder (GAD) and panic attacks in adults. It's taken by mouth, typically 3 times a day or as directed by your healthcare team. To avoid the risk of dependence, alprazolam (Xanax) is meant for short-term treatment only. Some of the more common side effects of this medication include drowsiness and memory problems. You should avoid drinking alcohol while taking alprazolam (Xanax) because this can lead to serious interactions.

Indications for Xanax

Pros and Cons for Xanax

Pros

  • Taken by mouth
  • Can start to work in 30 minutes
  • Available as quick-dissolving tablets or liquid for people who have trouble swallowing pills

Cons

Common Side Effects for Xanax

Generalized anxiety disorder:

  • Drowsiness (41%)
  • Lightheadedness (21%)
  • Dry mouth (15%)

Panic disorder:

  • Drowsiness (77%)
  • Fatigue (49%)
  • Poor coordination (40%)
  • Memory issues (33%)
  • Irritability (33%)
  • Appetite changes (28-33%)
  • Thinking problems (29%)
  • Constipation (26%)

Side effects listed are for the immediate-release forms. Side effects for extended-release form might differ.

Warnings for Xanax

  • Sedation and difficulty breathing
  • Potential for misuse, addiction, dependence, and withdrawal
  • Effect on driving and concentration
  • Harm to babies
  • Interactions with other medications
  • Use with caution in people with depression

Prices with our coupons for Midazolam vs. Xanax

Price Card Drug Icon
Midazolam1 vial / 2ml of 5mg/ml
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Alprazolam30 tablets / 0.5mg
$8.65$18.20
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