Taking Xanax on an Empty Stomach: Is It Good or Bad?

The basic ground for choosing a medication to take before, during, or after meals is to forecast how the drugs will interact with the digestive system as the drug-food reactions affect the absorption of chemicals from that medicine.

Like any other drug, taking Xanax on an empty stomach has both beneficial and harmful effects. Let me guide you through them for a better understanding.

Is taking Xanax while fasting a requirement?

Xanax or alprazolam is a fast-acting benzodiazepine that works by binding with a specific receptor called gamma-aminobutyric acid (GABA) receptors and prevents the neurotransmitter GABA from binding with their specific receptors. This increases the amount of GABA in the brain producing a soothing effect on the body.

Now, you must be wondering does food intake affect the effects of Xanax on the body?

The answer for most people would be a “NO”. Xanax can be taken with or without food and without causing a significant change in its effects. However, it varies for a lot of people. For some, taking Xanax on an empty stomach is more effective while others feel different.

taking Xanax on an empty stomach can be harmful

Although the effects differ individually, the drug mostly affects less when it is taken in a full stomach. Benzodiazepines are lipid-soluble drugs so when the drug is taken with food, and both the drug and the food reach the intestine, there is a competition between the food and the drug for absorption by the intestine. Thus food reduces the rate of absorption of the drug in the intestine resulting in a delay in the action.

According to scientific research on the effect of food on alprazolam and other benzodiazepines, the overall extent of absorption of Xanax remains unaffected during fed conditions but the rate of absorption is slower. So, do you need to eat before Xanax? My suggestion would be to check the effects and consult with your doctor.

Since Xanax is an anti-anxiety pill and needs immediate action in case you’re having a panic attack, it is probably best to take Xanax on an empty stomach.

What is considered an empty stomach?

Very often, doctors prescribe drugs mentioning that it has to be taken on an empty stomach. Exactly how much is “empty”?

According to the US Food and Drug Administration(FDA), an empty stomach is achieved 1-hour before eating and 2-hours after eating. 

Nonetheless, this is just a theoretical rule and the duration will differ depending on other physiological factors like gastric emptying time, eating habits of an individual. For some people, the duration might even extend to 8-hours of no food for experiencing the maximum effect of Xanax. While the rule of thumb proposed and established by the FDA might just work fine for the rest.

Cons of taking Xanax on an empty stomach

The list of cons after taking Xanax on an empty stomach is small but they can affect you badly. Before you start the medication take a look at those demerits.

Xanax addiction

The faster a substance enters the body, the faster it leaves. Although the fact that the drug is eliminated from the body sooner sounds like an added advantage. Rapid absorption results in rapid tolerance and hence drug abuse leading to addiction. Xanax addiction is a rising problem now caused by Xanax abuse which occurs when the medication is taken more than prescribed or when the prescribed amount is too much for you.

Be aware of not taking the drug when not absolutely required and discuss with your doctor to know how long to continue to avoid chances of being addicted.

Breakdown in stomach

Sometimes, Xanax can be broken down in the stomach due to the action of stomach juices on the drug. However, the extent of breakdown will depend on how the oral drug form is made. This is one of the most prominent cons of taking Xanax on an empty stomach.

Rapid excretion

Medicine might be washed away before it can bring about its effects on the body. It might also not be absorbed in the bloodstream properly as it has a very short half-life and will be washed away spontaneously.

More pronounced side effects

Taking Xanax while fasting can result in harsh gastric side effects like stomach irritation, stomach ache resulting from acid reflux, indigestion, ulcer, or inflammation. It can also result in an upset stomach causing loose stool.

taking Xanax on an empty stomach

As the drug will be absorbed quickly in the bloodstream on an empty stomach, it will be effective sooner but it will also bring along its side effects sooner. Side effects of Xanax will make you feel tipsy and result in symptoms like drowsiness, tiredness, memory problems, trouble concentrating, and a headache. It can also result in severe side effects like intensifying anger, increased sweating, muscle weakness, dry mouth, and even sexual problems like loss of interest in sexual intercourse.

Routes of administration of Xanax

Considering the disadvantages associated with the intake of Xanax in its oral form, many opt to take the drug in other forms. How the effect of taking Xanax on an empty stomach will depend partially on the routes of administration too.

Sublingual route

Taking a drug sublingually means placing a drug under your tongue to dissolve and absorb into the bloodstream from the tissue there. People often choose this route because it dissolves easily and has a faster onset of action as it bypasses the liver and so is not exploitable by the first-pass metabolism.

However, Xanax has to be manufactured specifically for sublingual absorption because altering the oral form increases the activity of the drug abruptly which can cause addiction. Xanax also tastes bad if the oral form is put under the tongue but people usually get used to it with time. Getting used to the foul taste of the drug can be even more dangerous and is an alarming sign for developing tolerance.

Rectal route

Drugs taken through the rectal route are absorbed faster than most other routes but it is not effective if the whole pill is given. The oral form of the drug has to be crushed and made into a solution or emulsion and introduced into the rectum using an oral syringe. However, the concentration of the drug will be changed if the solution or emulsion is not made carefully. Withal, inserting the drug is quite a task.

Inhalation

The powder form of Xanax is the fastest and most effective way to get the drug into the systemic circulation. It only takes two minutes to start working compared to the 2-3 hours required in oral form.

Although other forms are more effective and act faster, the major risk of rapid action is rapid tolerance development. Rapid tolerance makes people more prone to taking more drugs than prescribed or required because they can’t feel any change after taking Xanax like they used to. Hence, altering oral form to take drugs in any other route is highly risky and not recommended at all.

Factors affecting Xanax absorption: dos and don’ts

Is it bad to take a Xanax on an empty stomach?

Yes, taking Xanax without any food in the stomach can create several side effects. However, the interaction of Xanax with different foods and drugs can also vary. I have compiled some dos and don’ts when you are taking this anti-anxiety medicine.

Xanax food interactions

Grapefruit juice

Grapefruit juice can cause severe drug reactions when taken with Xanax. Grapefruit and grapefruit-containing juice reduce absorption by affecting liver enzymes that metabolize Xanax. Thus consumption of grapefruit juice can worsen the impact of taking Xanax on an empty stomach.

taking Xanax on an empty stomach

This in turn reduces the metabolism of Xanax increasing its duration of stay in the body. Thus causing adverse effects. Orange juice, however, does not have any effect on Xanax absorption.

Alcohol

Alcohol intake is strictly prohibited when you’re taking Xanax. The exact mechanism is unknown but since Xanax is a central nervous system depressant and so is alcohol, alcohol alters Xanax absorption and causes major drug-food reactions.

Caffeine

If you’re taking Xanax for sleeping, limiting caffeine is the way to go as it defies the purpose of having Xanax. Nonetheless, caffeine intake increases the uptake of Xanax into the systemic circulation.

Xanax drug interactions

Xanax reacts with over 492 drugs but it causes major adverse effects with some regularly taken pills such as:

Omeprazole or Cimetidine

These drugs are taken for reducing acid burn and heartburn caused by acid reflux. Their interactions with Xanax are not that significant but if you take any of them with Xanax without any food the repercussions of taking Xanax on an empty stomach will be troublesome.

Oral Contraceptive Pills

Xanax also reacts with oral contraceptive pills which can be very inconvenient if you are suffering from chronic anxiety disorders cause you’ll have more on your plate to worry about. Oral contraceptive pills reduce clearance and increase the plasma half-life of Xanax so Xanax stays in the body for a longer time resulting in adverse reactions.

Tramadol and other analgesics

Commonly taken to treat mild to moderate pain. Pain causes the body to be in a stressed condition causing anxiety but make sure to not take tramadol or other analgesics with Xanax cause it can result in side reactions.

Narcotic opioids

This can also cause moderately adverse reactions with Xanax so intake should be avoided. And taking Xanax on an empty stomach with narcotic opioids can worsen the side effects.

Xanax Disease interactions

Obesity

Obesity prolongs plasma half-life due to increased distribution into fat so longer dose intervals should be prescribed and careful monitoring is required.

Renal/liver disease

Xanax is metabolized in the liver and excreted by the kidney through urine so impairment of both will affect Xanax absorption, distribution, and excretion.

Acute alcohol poisoning and respiratory depression

Both exhibit vital depressive sign symptoms which get even more severe when Xanax is taken as it is a CNS depressant too.

Others

Xanax should be avoided during pregnancy and lactation as it causes fetal abnormalities. It should also be avoided with smoking/marijuana.

There is no change in the effect of Xanax when taken with tea but most people ask about Xanax tea effects which is what I’m going to talk about now.

Xanax tea

Xanax tea or kava is a natural alternative that is derived from a south pacific plant with psychotropic and sedative effects mimicking Xanax. It contains a substance called kavalactone which binds with receptors that Xanax and alcohol bind to too. Traditionally it was used as a drink in holy activities but now it is sold as medicine in health-food stores in the USA.

kava tea can minimize the effect of taking xanax on an empty stomach

People usually consume Xanax tea or kava-kava root to reduce work-related stress or anxiety but it should be taken with extra caution as it results in displeasing side effects like nausea, vomiting, indigestion, and even liver problems. Hence it is not advised to be taken for more than three months and a doctor’s advice is required.

Conclusion

Although several disadvantages and factors are affecting the absorption of Xanax, it is best absorbed when taken on an empty stomach. However, it will vary from person to person so try taking Xanax on both fasting and fed conditions with precaution to know what suits you best.

Otherwise understanding the effect of taking Xanax on an empty stomach won’t be clear to you.

FAQ

How long should I wait to eat after taking Xanax?

For many people, there is only some noticeable difference. Some do stay fasting for a while after they have taken their Xanax until they can feel the effect but the duration varies for different individuals depending on your body type, eating habits, workout schedule, etc.

Try out what works best for you but don’t forget to include your doctor because you might develop a tolerance while you’re trying.

How can I tell if Xanax is working?

The answer is very simple. If Xanax is working in your body, your anxiety will be relieved and your body will feel relaxed. You’ll be calm and will be able to concentrate better. The effects are very much noticeable if Xanax is working.

This is Dr. Hafeez. I have done my M.Phil in Pharmacology. I am a healthcare professional. My core competencies focus on writing different types of research articles/blogs regarding health sciences.

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