11 Medications That Are Dangerous to Stop Abruptly

There are many reasons you may want to stop taking a medication. Maybe you’re getting unwanted side effects. Or, perhaps, it’s not working as well as you hoped. Cost or refills could be a factor, too. No matter the reason, you may understandably feel tempted to stop your medication without talking to your healthcare professional first – but not so fast.

Some medications can be dangerous to stop abruptly. Not only could your medical condition get worse, but you could also experience problematic side effects or withdrawal symptoms. And with some medications, such as antidepressants, stopping cold turkey is riskier the longer you’ve been taking them. The dose of some medications need to be gradually lowered (tapered). Your prescriber can help you with a taper plan to slowly lower your dose over a period of time.

Below, we’ll talk about 11 medications that may lead to serious problems if stopped abruptly.

Keep in mind: This list isn’t all inclusive. Other medications, such as insulin, blood thinners, and thyroid medications, can also be dangerous to stop abruptly.

1. Clonidine

Clonidine (Catapres, Nexiclon XR) is a medication that’s used for high blood pressure, attention-deficit hyperactivity disorder (ADHD) in children, and Tourette syndrome. It’s also sometimes taken off-label for other conditions, such as smoking cessation and opioid withdrawal.

Clonidine works by telling your brain to stop making a chemical called norepinephrine. Norepinephrine helps keep your blood pressure normal and allows you to stay focused. But too much can cause high blood pressure, stress, and anxiety. Stopping clonidine abruptly can cause a surge of norepinephrine. This can cause “rebound hypertension,” where your blood pressure suddenly increases to dangerous levels. This may also cause withdrawal symptoms such as nervousness, headache, and shakiness. 

Before stopping clonidine, talk to your prescriber about alternative medicines. And if it’s safe to do so, they can come up with a plan to safely lower your clonidine dosage gradually.

Good to know: Clonidine comes in many forms, including tablets, skin patches, and an injection. Rebound hypertension can happen no matter what form of clonidine you’re using.

2. Propranolol and other beta medications

Propranolol (Inderal LA) treats many heart conditions. These include high blood pressure, chest pain, and irregular heart rhythms. Other FDA-approved uses for propranolol include treating tremors, managing a specific tumor of the adrenal gland (pheochromocytoma), and preventing migraines. It’s also sometimes used off-label for performance anxiety.

Propranolol is part of a group of medications called beta blockers. Beta blockers slow down your heart rate and prevent your heart from pumping as hard, which can help lower your blood pressure. Stopping a beta blocker suddenly may lead to withdrawal, causing symptoms such as:

• High blood pressure

• Chest pain

• Anxiety

• Fast heartbeat

• Heart attack

All beta blockers have the potential to cause withdrawal symptoms. It’s more likely to happen if you’re taking larger doses and have been receiving them for at least 6 weeks.

If you need to stop your beta blocker, talk to your prescriber about a plan for slowly decreasing the dose — this is especially important if you’re taking clonidine at the same time as a beta blocker.

3. Losartan and other blood pressure medications

Losartan (Cozaar, Arbli) is a type of blood pressure medication called an angiotensin II receptor blocker (ARB). ARBs cause your blood vessels to relax, which helps lower your blood pressure. They also prevent your body from holding on to salt and extra water. This takes unnecessary strain off the heart and kidneys and makes them beneficial for preventing stroke, heart attack, and diabetes-related kidney damage.

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The side effects of stopping losartan aren’t the same as with clonidine and beta blockers. You aren’t likely to experience immediate withdrawal symptoms. But you’ll eventually see an increase in your blood pressure, which can lead to problems down the road.

Check in with a healthcare professional before stopping losartan or any other blood pressure or heart medications, including:

• Calcium channel blockers, such as amlodipine (Norvasc) and diltiazem (Cardizem)

• Angiotensin-converting enzyme inhibitors, such as lisinopril (Zestril, Qbrelis)

• Diuretics, such as spironolactone (Aldactone) and furosemide (Lasix)

Abruptly stopping any blood pressure or heart medication can be risky. Treating your blood pressure helps prevent future stroke, heart attack, and heart failure.

4. Venlafaxine

Venlafaxine (Effexor XR) is part of a group of medications called serotonin and norepinephrine reuptake inhibitors (SNRIs). It can treat conditions such as depression, anxiety, and panic disorder. 

Stopping venlafaxine too quickly can lead to withdrawal symptoms. Symptoms usually start 24 to 48 hours after stopping the medication and may include:

• Irritability

• Nausea

• Vomiting

• Dizziness

• Nightmares

• Headache

• Tingling sensation on skin (paresthesia)

Talk to your prescriber before stopping venlafaxine. They’ll likely recommend that you lower your dose slowly. In studies of venlafaxine extended-release, doses were lowered by 75 mg every week until the medication was stopped. Sometimes, the dose may need to be lowered over several months to avoid withdrawal symptoms.

5. Paroxetine

Paroxetine (Paxil) is part of a group of medications called selective serotonin reuptake inhibitors (SSRIs). It’s used to treat conditions such as depression, anxiety, and certain menopause symptoms.

Paroxetine is the SSRI that’s most likely to cause withdrawal symptoms. It generally needs to be tapered gradually prior to stopping it. If you stop taking it suddenly, symptoms may include:

• Nausea

• Headaches

• Dizziness

• Anxiety

• Confusion

• Irritability

• Trouble sleeping

If you’re taking paroxetine and thinking about stopping it, talk to a healthcare professional about how to safely taper it down.

6. Benzodiazepines

Benzodiazepines, such as alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium), are used for anxiety symptoms and panic attacks. They’re also prescribed off-label for a variety of other conditions, including insomnia and alcohol use disorder.

Benzodiazepines shouldn’t be stopped abruptly. Withdrawal symptoms — including seizures — may occur if you suddenly stop taking them. Seizures can happen soon after stopping the benzodiazepine, but they can also occur days later.

Other benzodiazepine withdrawal symptoms may include:

• Headache

• Heart palpitations

• Sweating

• Nausea

• Trouble sleeping and nightmares

• Irritability or agitation

• Anxiety or panic attacks

• Delirium

Withdrawal is more likely to happen if you’ve been taking a high dose. They can also happen if you have been taking medication for a long time. Withdrawal symptoms usually appear within 2 to 5 days after stopping a benzodiazepine.

Lowering your dose slowly with the help of your healthcare professional can help you avoid serious withdrawal symptoms.

7. Topiramate

Topiramate (Topamax, Qudexy XR, Trokendi XR) is approved to treat seizures and prevent migraines. It’s also one of the two medications in Qsymia (phentermine / topiramate), which is used to promote weight loss. And it’s used off-label to treat alcohol use disorder, too.

Topiramate withdrawal can occur when it’s stopped abruptly instead of tapered. The greatest risk is that your seizures worsen. Instead of stopping topiramate at once, your healthcare professional can help you taper your dose gradually. 

8. Gabapentin

Gabapentin (Neurontin) is approved to treat seizures and nerve pain. It’s also used off-label to treat withdrawal symptoms in alcohol use disorder. But, you shouldn’t stop taking gabapentin suddenly. Withdrawal symptoms can start as soon as 12 hours after stopping it. 

Gabapentin withdrawal symptoms occur more commonly in people taking this medication at a high dose or in those who take it for a long time. They include:

• Agitation

• Anxiety and restlessness

• Tiredness

• Sensitivity to light

• Dizziness

• Irregular heartbeat

If you’re taking gabapentin for seizures, stopping it can cause seizures to return or worsen. This is why it’s important to talk to a healthcare professional about a plan before stopping gabapentin.

9. Prednisone and other corticosteroids

Prednisone is a corticosteroid medication that can treat many medical conditions, such as allergic reactions, inflammatory bowel disease (IBD), and other inflammation-related issues.

If you’ve been taking prednisone or another oral steroid for more than 3 or 4 weeks, you may experience withdrawal side effects if you stop it abruptly. It can also happen with higher doses, regardless of how long you’ve been taking it. This is because stopping corticosteroids abruptly can cause your adrenal glands to stop working correctly, and they won’t be able to produce enough of the hormones that help your body function normally. 

Stopping prednisone can lead to symptoms such as:

• Weakness

• Joint and muscle pain

• Nausea

• Trouble sleeping

• Mood changes

Depending on what you’re taking corticosteroids for, they’re usually prescribed in tapered doses. If not, make sure to talk to your healthcare professional about how to wean off the medication slowly.

10. Opioid pain medications

Opioids, such as codeine, morphine (MS Contin), and oxycodone (OxyContin), are prescription pain medications. If you’ve been taking an opioid for a long time, stopping it suddenly can cause withdrawal symptoms. You may start to notice these symptoms between 1 to 3 days after your last dose and may experience symptoms such as:

• Sweating

• Diarrhea

• Muscle pain

• Restlessness

• Anxiety 

If you need an opioid for pain management, taking the lowest dose for the shortest amount of time possible can help you avoid opioid withdrawal symptoms. Taking less medication means it is easier to stop later on. But if you’re taking an opioid medication long-term, it’s best to wean off the medication instead of stopping abruptly.

11. Baclofen

Baclofen (Fleqsuvy, Ozobax DS, Lyvispah) is a type of muscle relaxer. It treats muscle spasms in people with spinal cord injury or multiple sclerosis.

Withdrawal from baclofen can occur from injectable or oral dosage forms. Withdrawal symptoms include: 

• Fever

• Weakness

• Nausea

• Worsening muscle spasms

Withdrawal from the injectable forms tends to be more severe. It can cause hallucinations, delirium, and seizures. If left untreated, it can even cause death.

If you’re taking oral baclofen or receive injectable baclofen, don’t stop your medication abruptly. Talk to a healthcare professional about how to wean slowly if it’s no longer needed.

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Written by:

Rachel Feaster, PharmD, BCOP, BCPS

Rachel Feaster has over 10 years of professional experience in ambulatory, inpatient, pharmacogenomics, and oncology care. She is board certified in oncology and pharmacotherapy.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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