Healthy pregnancy hub

Alprazolam (Xanax®)

Last Update: 02 Oct 2025

Welcome to our fact sheet on alprazolam during pregnancy and breastfeeding or chestfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

The HEALTHY PREGNANCY HUB team is collaborating with MotherToBaby to share information on this topic. The original version is available here (August 2024).

Serene, our chatbot, can also answer your questions about medications during pregnancy.

Please note that this fact sheet is based on United States information and has been adapted for Canada, with a review by our Canadian experts. Minor differences may exist between the two countries. Always consult your healthcare professional for information tailored to your situation.

1. What is alprazolam?

Alprazolam is a medication that has been used to treat anxiety and panic disorder, including anxiety associated with depression. It is in a class of medications called benzodiazepines. Alprazolam is sold under the brand names Xanax®, Niravam®, or Gabazolamine-0.5®. 

Sometimes when people find out they are pregnant, they think about changing how they take their medication or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. If you take this medication regularly and then suddenly stop taking it, you could have withdrawal symptoms. Some reported withdrawal symptoms include seizures and rebound anxiety. Also, untreated anxiety and depression can increase risks to a pregnancy. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

For more information consult our factsheets on anxiety here and on depression here.

2. What does research say about the risks during pregnancy?

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

It is not known if alprazolam can make it harder to get pregnant. 

Does taking alprazolam increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is unlikely that alprazolam would greatly increase the chance of miscarriage. 

Does taking alprazolam increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. 

Most studies on alprazolam use in the first trimester have not reported an increased chance of birth defects. Two reports that looked at prescription records reported a higher chance for heart defects if a prescription for alprazolam was filled during pregnancy. Studies based on prescription records cannot tell if a person took the medication, so it is hard to know if the outcomes are related to the medication or other factors. Overall, an increased chance of birth defects has not been proven. 

Does taking alprazolam in pregnancy increase the chance of other pregnancy-related problems? 

Some studies have suggested that alprazolam might increase the chance of preterm delivery (birth before week 37) and low birth weight (less than 5 pounds, 8 ounces [2500g] at birth). Other studies have not found this association. 

I need to take alprazolam throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of benzodiazepines (including alprazolam) during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal and can include trouble regulating body temperature, trouble breathing, low energy, poor feeding, and vomiting. Most often, symptoms start soon after birth and could last several days. Not all babies exposed to alprazolam will have symptoms. It is important that your healthcare providers know you are taking alprazolam so that if symptoms occur your baby can get the care that is best for them. 

Does taking alprazolam in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if alprazolam can cause behavior or learning issues for the child. 

3. Breastfeeding​/ chestfeeding​ while taking alprazolam

Alprazolam gets into human milk. While it is possible to nurse while taking alprazolam, a different medication might be preferred. If you suspect the baby has any symptoms (being too sleepy, poor feeding, and poor weight gain), contact the child’s healthcare provider. After a single dose of alprazolam, there is usually no need to wait to breastfeed or chestfeed. 

The product label for alprazolam recommends people who are breastfeeding or chestfeeding not use this medication. But the benefit of treating your condition and breastfeeding or chestfeeding may outweigh possible risks of taking alprazolam. Your healthcare providers can talk with you about using alprazolam and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding or chestfeeding questions. 

4. What about fathers and sperm donors?

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

There is one report of a male who had delayed ejaculation and impotence (trouble with getting and keeping an erection) while taking alprazolam. One small study found lower sperm motility (movement) in those taking psychotropic medications (including alprazolam) compared to males who did not take psychotropic medications. These issues may make it harder to conceive a pregnancy. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures here.

Key points

  • Alprazolam (Xanax®) is a benzodiazepine medication used to treat anxiety and panic disorders, including anxiety linked to depression. 
  • Alprazolam does not appear to increase the risk of miscarriage or birth defects when taken during pregnancy, but more research is needed. 
  • Some studies suggest a possible link to low birth weight or preterm birth, but results are mixed. 
  • Use during pregnancy may cause temporary symptoms in newborns, such as trouble breathing or feeding. Not all babies will be affected. 
  • Alprazolam passes into human milk. It’s important to discuss with your healthcare professional if you want to breastfeed or chestfeed to find the best option for you and your baby.
  • Always talk to your healthcare provider before making any changes to your medication during pregnancy or breastfeeding/ chestfeeding.

References

Please click here for references. 

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Disclaimer

HEALTHY PREGNANCY HUB provides a source of information validated by health professionals; however, this information is provided for informational purposes only and should not replace professional advice. Medical standards and practices evolve as new data becomes available, so it is imperative to consult your doctor or a qualified health professional for any questions or concerns regarding your health without delay or omission. It is the responsibility of your treating physician or any other health professional, based on their independent experience and knowledge of the patient, to determine the best way to evaluate and treat you.

HEALTHY PREGNANCY HUB does not specifically recommend or endorse any test, practitioner, treatment, product, or opinion mentioned on our platform. HEALTHY PREGNANCY HUB also does not replace the individual patient assessment based on the examination by the healthcare provider of each patient and the consideration of laboratory data and other patient-specific factors.

The use of the information available on our site is at your own risk. No person involved in the creation, production, promotion, or marketing of HEALTHY PREGNANCY HUB guarantees or represents, expressly or implicitly, anything regarding the information available on the platform, which is provided “as it is”. All warranties are expressly excluded and disclaimed, including but not limited to implied warranties of merchantability or fitness for a particular purpose, as well as any warranties arising by law or otherwise in law or from trade or usage. Any statements or representations made by any other person or entity are void.

While consulting symptoms or other medical information on our platform may guide your discussions with your healthcare professional, this information should not be used to make a medical diagnosis or determine treatment. Before making changes to your supplement or medication regimen, please discuss with your medical team or contact 811 (Canada) to ensure the relevance of these changes to your individual situation.

Credits
MotherToBaby
Organization of Teratology Information Specialists (OTIS)
View source
Sasha Bernatsky
Research Institute of the McGill University Health Centre
Evelyne Rey
CHU Sainte-Justine
Émy Roberge
Centre hospitalier universitaire Sainte-Justine

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