Grapefruit Juice And Xanax: The Dangers Of Potentiating Alprazolam

Medically Reviewed by Johnelle Smith, M.D on April 23, 2020

Mixing grapefruit juice and Xanax (potentiating Xanax) can have harmful to dangerous consequences. Treatment for Xanax abuse can help a person avoid these side effects and manage substance abuse and addictive behaviors in order to enter recovery.

Dangers Of Mixing Grapefruit Juice And Xanax

Xanax, generic name alprazolam, is a type of sedative called a benzodiazepine. Unfortunately, it has a significant risk of addiction, so doctors prescribe it for short-term use only. Despite this, abuse of Xanax has spiked since 2002. Deaths from Xanax overdose went up four-fold between 2002 and 2015, largely because of an increase in Xanax prescriptions.

Many of those overdoses occurred because Xanax was combined with another drug, most often alcohol or opioids. Alcool, opioids and benzodiazepines act to depress the central nervous system, and when they are taken together, they can depress it to the point where such vital functions as breathing and heart rate slow down until they simply stop.

Some people may mix Xanax with other substances as well to enhance its effects. People may mix grapefruit juice and Xanax in order to bring about a faster onset of effects or because they believe it will increase the desired effects of the drug.

Yet mixing alprazolam and grapefruit juice can have dangerous consequences, from mild side effects to harmful effects that can land a person in the hospital. Learn more about the dangers of potentiating alprazolam, what happens when you mix grapefruit juice and Xanax, and why it’s important to seek help for Xanax addiction.

Xanax And Its Uses

Like other benzodiazepines, Xanax was developed to replace barbiturates, which scientists thought were unacceptably addictive. Xanax is used to ease anxiety and panic disorders as well as the depression that arises from anxiety.

It produces a pleasurable calm and tranquility that some users come to depend on. As the dependency grows, patients may find they have to take more and more Xanax for the same effect. They become physically dependent when they must take the drug to simply feel normal and avoid withdrawal symptoms. If a person can no longer feel the effects of the drug, they may begin abusing it.

Since Xanax can only be obtained by prescription, patients may go to several doctors to make sure the drug is prescribed, or buy the drug off the street. This is when Xanax is most dangerous, for street Xanax is sometimes cut with other drugs such as the powerful and dangerous opioid fentanyl.

Conditions Xanax (Alprazolam) Is Used To Treat

Besides anxiety and panic disorder, Xanax is also used to treat insomnia and the nausea that often accompanies chemotherapy. It works by rebalancing neurotransmitters and other chemicals in the brain. Xanax binds to the receptors of a chemical called gamma-aminobutyric acid, or GABA. This causes the central nervous system to calm down.

Xanax is taken in tablets that can come in four dosages, and each tablet has a different color to tell them apart. The effects are felt after about an hour. Xanax stays in the body for about 12 to 15 hours and takes two weeks to achieve a level where the patient notices improvement in their disorder.

Xanax Side Effects

Like most drugs, Xanax can have side effects even when taken properly. These side effects can be common, less common, or rare.

They include:

  • ataxia, which is a loss of full bodily control
  • constipation
  • difficult urination
  • fatigue
  • memory loss
  • rash
  • weight gain
  • weight loss
  • mental confusion
  • increased hunger
  • decreased hunger
  • blurred vision
  • difficulty speaking
  • insomnia
  • decreased libido

Some of these side effects go away after time, or they can be prevented. A person should consult their doctor if Xanax side effects persist.

Mixing Xanax And Grapefruit Juice

One of the stranger medical facts is that grapefruit juice should never be taken with certain medications. Grapefruit juice and Xanax is one of the pairs that should never be taken together. The dangers of mixing grapefruit juice and Xanax are serious, as grapefruit has a chemical that can affect the liver enzymes that metabolize Xanax.

Grapefruit and grapefruit juice have chemicals called furanocoumarins that stop the action of an enzyme called CYP3A4. When this enzyme doesn’t work, the amount of Xanax in the system can build up to dangerous levels. This can lead to an overdose of the drug even if the patient takes what they believe is a normal dose.

Side Effects Of Mixing Xanax And Grapefruit Juice

Due to the way grapefruit juice interferes with the breakdown of Xanax in the body, a person may experience multiple effects when mixing the substances.

The side effects of mixing grapefruit juice and Xanax include:

  • drowsiness
  • clumsiness
  • dizziness
  • problems speaking and breathing
  • difficulty concentrating
  • hypersalivation

This combination may even bring on symptoms that Xanax is supposed to ease, such as anxiety, restlessness, and suicidal ideation. These are called paradoxical effects. The real dangers of mixing grapefruit juice and Xanax come when the patient tries to operate heavy machinery or drive.

Dangers Of Alprazolam Potentiation

The dangers of potentiating alprazolam arise when Xanax is taken with another substance that enhances its effects or enhances the effects of both substances.

This can be seen when the patient takes Xanax with alcohol or an opioid. This can easily lead to an overdose as both drugs work to decrease the patient’s breathing, heart rate, and other actions of their central nervous system.

If a person is abusing both Xanax and alcohol or Xanax and opioids and chooses to take them with grapefruit juice, this could lead to dire consequences, including overdose.

Xanax Abuse And Other Drug Interactions

Besides the dangers of potentiating alprazolam, Xanax and other substances or even bodily systems can interact in other ways. Three of these are antagonism, synergism, and metabolic interactions.


Antagonism happens when two drugs are taken together and one reduces the effect of the other. Sometimes, the effects of both are reduced. This can happen when Xanax, a sedative, is taken with a stimulant such as cocaine. The effects of both drugs are weakened.


Synergism happens when an effect, beneficial or otherwise, happens when two drugs are used together. The effects would not happen if the drugs were used singly. Some scientists believe that alcohol and Xanax work synergistically together as well as potentiate each other. The effect of the two drugs taken together is to increase the sedation of Xanax and increase the intoxication brought by alcohol.

Metabolism Interactions

Metabolic interactions occur when bodily systems either slow down or speed up how fast Xanax is eliminated from the body. For example, patients with kidney or liver disease might not be given Xanax or may be given Xanax at lower than normal dosages.

This is because damaged renal and liver systems have trouble processing Xanax, which is broken down by the liver and whose metabolites are excreted by the kidneys.

Even obesity can affect how Xanax reacts in a person’s body. Because of the excess fat, it may take longer for the drug to be metabolized. The doctor may prescribe a longer interval between dosages for an obese patient.

Can You Overdose When You Mix Xanax And Grapefruit Juice?

Since grapefruit juice prevents the liver enzymes from breaking down Xanax properly, it is possible to inadvertently overdose when a patient takes grapefruit juice along with Xanax. The symptoms resemble a mild overdose of alprazolam. The good news about Xanax overdose is that it is rarely fatal unless the drug is taken with another drug that potentiates it.

Treatment For Xanax Abuse And Addiction

There is treatment for people who are struggling with addiction to Xanax. Depending on the needs of the patient, they can enter outpatient, inpatient, intensive outpatient, or partial hospitalization programs where they can detox from the drug safely and under supervision and learn to live a sober lifestyle.

A person who is addicted to Xanax or any benzodiazepine should never abruptly stop use of the drug, as this can lead to withdrawal, which can have harrowing symptoms.

Get help for you or a loved one before experiencing the harmful effects of mixing Xanax and substances like grapefruit juice or other drugs. To learn more about Xanax detox programs and addiction treatment programs, contact one of our treatment specialists today.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D on April 23, 2020
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