Alprazolam cannot be bought without a prescription through secure household delivery flows as a Schedule IV controlled substance requiring a valid EPCS prescription from a DEA-registered US healthcare provider for short-term anxiety or panic disorder management; no-Rx delivery constitutes federal felony distribution under 21 U.S.C. § 841 with up to 20-year imprisonment penalties.​
Dosing starts at 0.25-0.5mg TID maximum 4mg/day divided doses under 2025 guidelines emphasizing lowest effective dose shortest duration (<2 weeks), with DEA telemedicine flexibilities expiring December 31, 2025 mandating synchronous HIPAA video HAM-A ≥20 confirmation and multi-state PDMP clearance—no household flow bypasses post-flex in-person initiation across 50 states.​
Alprazolam (GABA-A α2/α3 agonist Ki 0.5nM), Tmax 1-2h, t½ 11-15h CYP3A4 metabolized; black box warnings include 30-50% dependence week 2, respiratory depression OR12 with opioids, anterograde amnesia 15-25%—taper 0.125mg weekly over 4-8 weeks C-SSRS monitoring; contraindications acute glaucoma, severe respiratory insufficiency, pregnancy D.​
Diagnostic: HAM-A ≥20 + 6-month collateral excluding mimics via PDSS.
Screening: PDMP zero fills 12mo, MoCA ≥26, orthostatics stable, UDS negative.
EPCS: #90 tabs ≤5 refills/6mo pharmacy-direct signature delivery.
Monitoring: ≥25% HAM-A q14-30d + UDS/pill counts taper triggers.​
| Incidence | Effect Cluster | Risk Factors | Management ​ |
|---|---|---|---|
| 30-50% | Sedation RASS -1/-2 | Elderly >1mg CYP3A4i | Morning dosing fall risk |
| 20-35% | Amnesia >30min | >2 weeks continuous | Neurocognitive q4w taper |
| 15-25% | Disinhibition | SUD history | SSRI substitution |
| 10-20% | Respiratory OR12 | Opioids | Naloxone 4mg IN standby |
| 5-15% | Paradoxical rage | Hepatic impairment | Olanzapine 2.5mg ​ |
Buy Alprazolam no-Rx secure household delivery flow violates CSA Schedule IV distribution (21 CFR 1306.04), Ryan Haight exam mandates (21 USC 802(54)), EPCS requirements—federal felony per transaction.​
| Supporters | |||
| Name | Date | Amount | Comments |
| Total | $0.00 | ||