crushing XR

[GroovyGwen]

Xanax in particular. I'm not going to do it, but I hate that I don't feel it for awhile then it will kick my ass. I know you are supposed to take it preventatively, but I don't take my meds in the AM until I eat something, usually after an hour or something. So then the X doesn't kick in for a bit after that.

[AirMarshall]

Xanax XR is NOT the form for you if you need immediate relief. As I recall, the immediate release form started working in about 20 minutes. The XR take a little under an hour for me, but I much prefer the steady level it gives thru the rest of the day.

I'm not clear why you can't take an XR as soon as you get up? I haven't noticed any stomach problems from taking it on an empyt stomach.

You can try crushing an XR tab, but the results may be unpredictable. My pharmacist sloppily substituted some higher dose XR's but split them to my rx's dosage. Theoretically cutting thru all the layers should have liberated all the meds at once, but it didn't work that way. It took me a while to figure out what was wrong.

I would caution that you could get an overdose of the med, depending on how it is designed. Here's how. Let's say the doc wants you to have 1mg in you bloodstream. So with the IR form, you take a 1mg tab every 4 hours, for a total daily dose of 4mg. But if the XR form contains the entire 4mg, and normally releases it slowly, but you crush it and then get 4mg all at once. You spike the meds and then it wears off too quickly and you don't have sufficient med in your body the rest of the day. You would need to ask your pharmacist.

a.m.

[LunaRufina]

Xanax in particular. I'm not going to do it, but I hate that I don't feel it for awhile then it will kick my ass. I know you are supposed to take it preventatively, but I don't take my meds in the AM until I eat something, usually after an hour or something. So then the X doesn't kick in for a bit after that.

Is there a reason you can't take just the xanax before you eat? Would that alone upset your stomach ?

I am trying to take my meds earlier but go back to sleep- it was sort of working for a while. But when it works [the sleep schedule that is] it seems to make the meds time just right. Is it an option to keep a bottle of water by your bed and take just the xanax right when you get up [then take the others after you eat like usual]?

Maybe you've tried all these and it's just not workin'. What's the reason for the XR instead of regular?

LR

[Sunshine]

I don't know about crushing and whether or not it will make it work faster, but I'm pretty sure it's okay to split Xanax XR tablets. At least my pdoc has told me it's fine. The tablets are not coated and don't have layers like a lot of the XR formulas, so I don't think this is how the dosage is getting distributed. I'll read the PI sheet and see if I can figure it out (but don't hold your breath - I'm no chemist!).

[Sunshine]

From the Official Pfizer PI Sheet:

I'm not entirely sure what this part means... AM might be able to decipher it. But I'm pretty sure that it means crushing the tablets won't increase the absorption rate.

Pharmacokinetics

Absorption

Following oral administration of XANAX (immediate-release) Tablets, alprazolam is readily absorbed. Peak concentrations in the plasma occur in one to two hours following administration. Plasma levels are proportional to the dose given; over the dose range of 0.5 to 3.0 mg, peak levels of 8.0 to 37 ng/mL were observed. Using a specific assay methodology, the mean plasma elimination half-life of alprazolam has been found to be about 11.2 hours (range: 6.3-26.9 hours) in healthy adults.

The mean absolute bioavailability of alprazolam from XANAX XR Tablets is approximately 90%, and the relative bioavailability compared to XANAX Tablets is 100%. The bioavailability and pharmacokinetics of alprazolam following administration of XANAX XR Tablets are similar to that for XANAX Tablets, with the exception of a slower rate of absorption. The slower absorption rate results in a relatively constant concentration that is maintained between 5 and 11 hours after the dosing. The pharmacokinetics of alprazolam and two of its major active metabolites (4-hydroxyalprazolam and α-hydroxyalprazolam) are linear, and concentrations are proportional up to the recommended maximum daily dose of 10 mg given once daily. Multiple dose studies indicate that the metabolism and elimination of alprazolam are similar for the immediate-release and the extended-release products.

It continues with this, which is somewhat interesting given that you are waiting until after you eat to take it:

Food has a significant influence on the bioavailability of XANAX XR Tablets. A high-fat meal given up to 2 hours before dosing with XANAX XR Tablets increased the mean Cmax by about 25%. The effect of this meal on Tmax depended on the timing of the meal, with a reduction in Tmax by about 1/3 for subjects eating immediately before dosing and an increase in Tmax by about 1/3 for subjects eating 1 hour or more after dosing. The extent of exposure (AUC) and elimination half-life (t1/2) were not affected by eating. There were significant differences in absorption rate for the XANAX XR Tablet, depending on the time of day administered, with the Cmax increased by 30% and the Tmax decreased by an hour following dosing at night, compared to morning dosing.

There's only one mention of crushing and/or breaking the tablets:

DOSAGE AND ADMINISTRATION

XANAX XR Tablets may be administered once daily, preferably in the morning. The tablets should be taken intact; they should not be chewed, crushed, or broken.

But based on the info about the pharmacokinetics, I'm not sure I understand why. Though like I said earlier, I don't think you would get a faster reaction from it if crushed.

FWIW, there's nothing that I could find in the PI sheet for the immediate release for or against breaking or crushing.

[Guest Tony]

I don't know about crushing and whether or not it will make it work faster, but I'm pretty sure it's okay to split Xanax XR tablets. At least my pdoc has told me it's fine. The tablets are not coated and don't have layers like a lot of the XR formulas, so I don't think this is how the dosage is getting distributed. I'll read the PI sheet and see if I can figure it out (but don't hold your breath - I'm no chemist!).