What is Xanax ?
Xanax or Alprazolam is one of the most popular benzodiazepine currently used on the world. It is used medically to treat acute panic and anxiety disorders. It is also helpful in treating psychological ailments like social phobia. The main mode of action of Xanax is by altering the neurotransmission of GABA (gamma amino butyric acid) particularly at the GABA-A receptor sites. It also has an effect of increasing the dopamine levels in the CNS.
The drug is very high in efficacy and is very often used on a short term basis as an SOS drug. The user normally takes it as and when required. The long term use has known to have some debilitating consequences. Most of the regular users develop resistance to the drug and so they tend to increase the dosage to continue getting the benefits. Long term use can lead to dementia and block the formation of new memories. This may inhibit the ability to use a vehicle and operate heavy machinery. The person may also face difficulties in carrying out his daily activities.
Xanax is a highly potential drug for abuse as it is very addictive in nature. Most of the users realise after some time that the drug is extremely habit forming and so they try to discontinue the use. They look for other safer alternatives. Individuals, who are under the effect of withdrawal symptoms of Xanax, often want to know how fast the drug will get cleared from the system.
How long does Xanax stay in your system ?
In case you have stopped taking the drug or are planning to discontinue xanax, then always do so under the guidance of a medical professional as you are bound to experience withdrawal symptoms. They can be dangerous and can disturb your ability to carry out the day to day activities. If you have completely stopped consuming xanax, then you may be wondering whether the drug is fully removed from the body or not. The elimination half life of xanax is 9 to 16 hours on an average in healthy normal adults.
Half life means the time taken for half of the drug to get metabolised and excreted from the body. It will take 9 hours to 16 hours for the body to remove the xanax till half its quantity. The average half life of xanax is 12 hours. This indicates that the 100% expulsion of the drug will take around 4 days.
The average clearance time is not fixed in all individuals and this will vary on individual variants like the age and buily up of the user. If you have a fast metabolism then you can eliminate the drug much faster than normal. Then the elimination time will be shortened to 2 days. If the excretion is slower and the metabolism is slow then the time taken by the body to get rid of the drug will be around 3 days. The half life time periods will vary in young and older users and so only an average time can be ascertained. The average half life of xanax is 19.7 hours.
Factors Affecting The Metabolism Of Xanax in Your Body
When understanding the metabolism of the drug, it is important to consider that the variation in the elimination times of the drug is based on individual factors and the interaction of these factors with each other decided the time taken by the body to get rid of the drug. One person may be able to clear the drug very fast from his body where as the other may take much longer. Now we shall consider each of these factors in details and understand how they affect the metabolism of xanax in the body. These are age, genetics, body built and co use of other drugs and supplements.
The people who take larger doses of xanax are able to metabolise the drug much faster than those who take relatively smaller doses. The standard dosing ranges between 0.25 to 0.4 mg when given to patients with anxiety disorders. Many uses who are taking the drug since a long time can tolerate doses larger then 0.4 mg as their body gets used to the effects of the drug.
The drug has a very high dependence rate and so in order to prevent the dependence, the doctors who prescribe such drugs try to keep the dosage low and prefer to give a minimal effective dose which is just enough to provide the symptomatic relief. The greater the dose of xanax you take, the more will be your bodys requirement. The tolerance threshold increases day by day. The less xanax you take, the faster the body will be able to eliminate the drug from the system.
If the drug is administered to two different persons at the same time with the same dosage and format in order to study the effect, it will be seen that one person has eliminated the drug much faster than the other. The ability of a person to metabolise xanax depends on the metabolism of the body and a multitude of other factors. These variables or factors include age, body mass, genetics, food and water intake and liver functions.
(a)Age: There are many differences in the elimination times of xanax in the body of young and elderly persons. Older individuals above the age of 65 are not able to metabolise the drug as effectively as young people mainly because of a sluggish liver function and various age related changes in the body. So the older you are, the longer your body will take to eliminate the xanax from the system.
(b)Height/Weight/Fat: The height, weight and the body mass of an individual affects the metabolism of xanax in the body. If a short heighted person takes a similar dose as a tall and hefty individual then the drug gets metabolised much faster in the hefty individual because the size of the drug dosage is small compared to their body size and so the clearance rate is much faster. So the height and weight of the person greatly affects the metabolism and thereby the clearance of the drug from the system.
(c)Liver & Kidney functions: Since the drug gets metabolised first in the liver, it is very obvious that any kind of derangement in the function of the liver will affect the metabolism of xanax. The drug is retained in the body for a much longer duration if the liver functions are normal. Liver diseases and decreased blood flow to the liver tends to impair or slow down the clearance of the drug. Renal function impairment may not directly affect the metabolism of xanax but it does have an effect on the overall elimination time.
(d)Genetics: Genes affect the ability of the body to metabolise certain drugs and so some users are categorised as rapid metabolizers and others as poor or slow metabolizers. This is mainly because of genetic variation in the CYP450 isoenzymes. The main location of the metabolism of xanax is the liver. The break down is mainly done by CYP3A4 isoenzymes which cannot get influenced by polymorphisms. After understanding this it is also important to consider that secondary isoenzymes may be under the effect of genetic influence. This may lead to slowdown or expedition of the metabolism of xanax.
(e)Metabolic Rate: The effect of the basal metabolic rate of a person on the metabolism of xanax is not very clear but it does influence the rate at which the body breaks down the drug. Some feel that people with a higher basal metabolic rate can excrete the drug much faster than others. People with a slower BMR will have a relatively longer clearance rate of the drug. Thus the BMR can influence the rate of clearance of the drug from the system.
(f) pH of Urine: There are no fixed findings that suggest the relation between the metabolism of xanax and urinary pH. But since the excretion occurs through the kidneys the ph could have an impact on the elimination time. It is a well known fact that alkaline urine tends to increase the re absorption of drugs and the metabolites. Acidic urine on the other hand will increase the excretion speed. So it can be said that users who have an acidic urine tend to eliminate the drug much faster than others.
(3)Use of other drugs and supplements:
If a xanax drug user takes other drugs and supplements along with the main drug, then the metabolism could well be altered. The drug could be a prescription drug or an over the counter prescription drug. The group of drugs that inhibit the function of CYP3A4 in the liver tend to prolong the breakdown and the absorption of xanax. This category of drugs are Cimetidine, Erythromycin, Ketoconazole, Ritonavir and SSRIs.
If a person takes any of the above drugs and supplements along with xanax, then it could lead to accumulation of the drug in the body. This accumulation can cause a delayed liver clearance. The other category of drugs that is known to interfere with xanax is oral contraceptives. They inhibit the complete metabolism of xanax and thereby the elimination gets affected. Some people who have a knowledge of these drugs may be taking them to speeden up or slow down the metabolism of xanax in the body.
There are some drugs that increase the breakdown of xanax by enhancing the effect of CYP3A4. This is known as inducing effects. These inducers can increase the average rate of clearance from 0.90 mL/min/kg to 2.13 mL/min/kg. Studies show that xanax gets eliminated much faster in smokers than in non smokers. This is just an observation and does not have any proofs as yet.
The examples of these drugs are:
- St John’s Wort etc.
(4)Frequency of consumption:
How often you take a particular drug has a very big impact on the metabolism and elimination of the drug. Long term users who take the drug on a regular basis will be able to metabolise the drug much more efficiently than short term users. This is mainly because of the fact that regular users tend to build up a tolerance for the drug and its effects.
Once a user is able to tolerate a particular dose, the tendency is to increase it. This is why xanax users normally take larger doses. The increase dosage and frequency of ingestion is too much for the body and so not all of it gets eliminated from the body. Some of the drug tends to stay back in the body tissues.
Those who take the drug infrequently or occasionally do not have an accumulation of the drug in the body as the small amount is rapidly metabolised and excreted from the system.
Details of Absorption, Metabolism and Excretion of Xanax
- After the oral ingestion of xanax, it gets absorbed and the peak plasma levels are achieved within 1-2 hours. The plasma levels are in sync with the dose of xanax ingested. If the dose is 0.5 to 3.0 mg, then the peak levels are somewhere between 8.0 ng/ml to 37 ng/ml. The active ingredient of xanax is alprazolam and it binds to the human serum protein.
- Then the drug reaches the liver where it gets metabolised by CYP3A4 and CYP3A1 isoenzymes. Then it gets broken down into the various metabolites and they are alpha-OHALP (alpha hydroxyl alprazolam), 4-OHALP (4-hydroxy alprazolam). Alpha OHALP is more active than 4-OHALP and it is also has a longer half life in the brain because of the property of hydrophilicity.
- Both the metabolites alpha OHALP and 4-OHALP makeup for only 4% of the plasma concentrations for any given dose of alprazolam. These are the two main metabolites but apart from these there are 29 other metabolites of xanax that have been identified. These metabolites are found in urinary excretion. After the breakdown of xanax in the liver, the metabolites will be excreted into the urine in the form of glucoronides.
- The elimination half life of the metabolites of xanax is very similar to that of the drug itself and they tend to get cleared from the system within 2 to 4 days. In most of the people who take xanax, the body will fully eliminate the drug through the urine in a period of one week of ingestion.
Drug Tests For Xanax
There are a number of drug tests that are available to check whether a person has consumed xanax or not. The commonest ones include urine tests, blood tests, hair analysis and saliva analysis. The standard drug test which is called SAMHSA-5 is unable to detect the presence of xanax. This test can only confirm the presence of drugs like amphetamines, opioids, cannabis, cocaine and PCP. For the detection of xanax and the metabolites, more extensive drug tests need to be employed.
A blood examination can be found positive for xanax for one full day post ingestion. If the individual is conscious then drawing blood can be considered as an invasive way of detecting the drug. Also the blood tests do not provide a long window period of detection as in urine tests.
Hair tests are a very good option of detection of xanax via the hair sample of the suspected user. The drug will aggregate in the hair outgrowth of the drug user. A sample that comprises of 20 to 50 hair strands needs to be sent to the laboratory for investigation and analysis. After the hair test, a more advanced test called RIA-radioimmunoassay can be used to confirm whether someone has taken xanax in the last four weeks. The detection is done on the basis of presence of the metabolites 4-OHALP and alpha OHALP.
The time taken by the hair to grow is nearly one month so the hair test is required to be done after that time. The results can give the prediction of the consumption of xanax one month before. If the test were to be conducted within few days on ingestion, then it would be negative. The detection of alprazolam is known to be more difficult than diazepam in a hair test.
Saliva tests are non invasive and simple tests to detect the consumption of xanax. The level upto which xanax can be detected in the saliva is 1 ng/ml. There are studies which prove that the maximum time for which alprazolam can be detected in the saliva is 2.5 days. Thus the window period for detection with a saliva test is much bigger than that of blood tests. The window period is however shorter as compared to urine testing.
Saliva test is simple to perform and non invasive in nature. The only problem is that clear salivary fluid needs to be collected and sent to the lab to get accurate results. Another issue is that these tests are more expensive compared to urine tests. Studies are on to make saliva tests more usable and less expensive. Eventually they will turn out to be more user friendly and easy to perform.
The commonest way of testing for xanax is through urine analysis. This type of testing is simple and non invasive. The urine sample of the suspected user is collected and sent for analysis to the laboratory. On excretion, about 20% of the drug will remain intact in the urine as original alprazolam. The metabolites like alpha OHALP will be detected very effectively by GC/MS that is gas chromatography/mass spectrometry when the level is more than 400 ng/ml.
Earlier it was thought that low dose usage may lead to positive urine tests for a period of 4 days after ingestion. Those who use the drug frequently and regularly tend to have a positive test for xanax for one week post ingestion. These results are assessed by urinalysis. The results of a urine test can be further confirmed by advanced technology like GC/MS.
Collection of a blood specimen from someone who has just taken the drug is a sure shot way to assess whether the person has taken the drug or not. It is invasive and more complicated than a urine test. If the patient has been hospitalized and the treating physician needs to ascertain whether he has taken the drug or not, then the blood test can be very useful. Patients with toxicity for alprazolam who may have taken very high doses of the drug can also be tested and confirmed for specific toxicity. Blood tests can be used to accurately detect the xanax within hours of taking the drug.
How To Clear Alprazolam From Your System
The half life of xanax is subject to strong individual variation and so the following tips may help you to clear the drug from the system rapidly
(1)Discontinue the drug: Stop taking the drug with immediate effect. If you are worried about withdrawal symptoms then take the guidance of a medical practitioner so that you do not start taking the drug again. Many users are addicted to the drug because of its anxiolytic effect and so they find it difficult to stop taking the drug.
(2)CYP3A4 inducers: Taking drugs that act as CYP3A4 inducers can increase the speed of elimination of the drug and so the drug gets cleared from the system very fast.
(3)Urinary pH: The pH of the urine has a very great impact on the drug clearance rate. An alkaline ph tends to promote the reabsorption of the drug and thus slow down the clearance rate of the drug. If the pH of the urine is acidic then the speed at which the drug is eliminated will increase.
(4)Exercise: People who exercise regularly can fasten their metabolic rate. An effective metabolism can help to clear the drug from the system more rapidly.
(5)Diet and hydration: Having a wholesome diet and adequate water can help to increase the speed of metabolism of xanax. Good hydration will make sure that the urinary output is increased and the drug and its metabolites are eliminated rapidly.
Uses of Xanax Drug Tests
The testing for alprazolam is not very commonly seen. If you are an athlete or are admitted to a rehab centre for drug withdrawal symptoms then you may be subjected to testing. The individuals tested for xanax may also be tested for benzodiazepine.
(1)Military Personnel: Individuals who are serving in the military need to be alert and ready at all times and so they are subjected to regular drug testing to determine if someone has consumed xanax or not.
(2)Employees: There are certain occupations like factory workers, drivers of trucks and heavy vehicles etc where the sedative effect of the drug can be detrimental. So they may be subjected to drug testing by their employers.
(3)Hospitalised patients: An unconscious patient is likely to be subjected to testing for drugs as the blood test can reveal both drug and alcohol toxicity.
(4)Athletes: Xanax has a sedative effect and so the athlete would not benefit from taking the drug during his active sessions as it would hamper his quality and output in the field. But its use a recreational drug is very common. Extensive drug testing may be used for athletes both professional and collegiate. If he/she tests positive for the drug then the result would be suspension or being banned from the sport.
(5)Drug Rehab Inmates: If you have recently stopped taking a drug then the withdrawal symptoms will be so strong that you may not be able to handle them and so admission to a rehab centre becomes a must. Rehab centres subject their clients to strict testing to ensure that they have remained sober and not started taking the drugs again. If someone is tested positive then their stay at the rehab centre will get prolonged.
Have You Undergone a Drug Test for Xanax.
If you have ever been tested for xanax, then tell us about your experience here. Mention the dosage and the frequency of ingestion of xanax. Accordin to you, how long did the metabolites stay in your body. Mention the details so that others can use the information too and understand how long it takes for the body to clear the xanax from the system.