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By Kajal Jain

M. Pharm

14 December 2022
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Table of Contents

Benzodiazepines are majorly recommended for people who are suffering from Anxiety. While these benzodiazepines are highly effective, they also come with certain risks.

Two of the most common prescriptions are Klonopin and Xanax, which have unique properties and efficacy in treating a medical condition. The psychiatrists weigh the dangers of Xanax and Klonopin and rarely prescribe them together, but that doesn't mean that some people don't find ways to use both in tandem.

If you have been prescribed any of these benzodiazepines or have been seeking a prescription to help you manage your Anxiety, you must do your research ahead of time.

Our brief guide can give you an overview of both medications and the dangers of abusing them and using them together.

What Is Klonopin?

Klonopin is a high-potency benzodiazepine anxiolytic medication used to treat Anxiety, panic disorders, and certain types of seizures. However, benzodiazepines are also used to treat alcohol withdrawal and sleep trouble.

Clonazepam is also known by its other name Klonopin. It was approved by the United States Food and Drug Administration (FDA) in 1975. It is less common for people to abuse Klonopin, so many psychiatrists feel more comfortable prescribing it.

It is also used off-label as mono or adjunctive therapy to treat restless leg syndrome, mania, insomnia, REM sleep behavior disorder, and tardive dyskinesia. It is a long-acting medication with a half-life of 30 to 40 hours.

What Is Xanax?

Xanax is a high-potency Triazolobenzodiazepine medication for treating various Anxiety and panic disorders (with or without agoraphobia). It is taken orally, and psychiatrists generally begin with a low dose to see how patients respond. Because of how commonly it's abused or used as a recreational drug, many psychiatrists prefer other options to Xanax unless the Anxiety resists other forms of treatment.

You can get Xanax online under its other known name Alprazolam. Xanax was approved by the U.S. Food and Drug Administration (FDA) on October 16, 1981.

Alprazolam is also off-label for treating sleep problems and depression, but its antidepressant effects have not been systematically evaluated. It reaches maximum effectiveness between one and two hours. 

How Does Klonopin Work?

Klonopin is a long-acting benzodiazepine that exerts its pharmacological action by acting as a positive allosteric modulator on the GABAA receptor. The GABAA receptor is a chloride ion-selective ligand-gated channel whose endogenous ligand is Gamma-aminobutyric acid (GABA). Benzodiazepines, however, don't have any effect on the GABA levels in the brain.

The anticonvulsant properties of Clonazepam and other benzodiazepines may be partly or entirely due to binding to sodium channels rather than benzodiazepine receptors.

Benzodiazepines (BZDs) facilitate the action of GABAA by increasing the frequency of chloride ion channel opening, resulting in the hyperpolarization of neurons, thus producing calming effects on the brain by reducing the excitability of neurons.

How Does Xanax Work?

Xanax (Alprazolam) is a benzodiazepine that binds to the GABAA receptor and shows its effect by enhancing the impact of the Gamma-aminobutyric acid (GABA) neurotransmitter in the brain. When attached to the GABAA receptor, the major inhibitory neurotransmitter GABA mediates the calming or inhibitory effects of Alprazolam on the human nervous system.

Can You Take Klonopin And Xanax Together?

While physicians will not prescribe Klonopin and Xanax together, some people choose to get them through their means. Using them recreationally or trying to hit their Anxiety harder isn't safe.

Some people combine them due to their difference in treatment. Because Xanax acts fast and the Klonopin lasts longer, they are under the impression that taking both will give them all-day relief.

Consuming combined medicines can show effects similar to taking too much of one or the other drug. They can cause gastrointestinal issues like nausea and vomiting. They may cause slurred speech, blurred vision, memory loss, and poor focus. 

Taking too much of both simultaneously leads to a depressed respiratory system,  difficulty breathing, stupors, and a severe drop in blood pressure. Severe though rare symptoms of a benzodiazepine overdose include respiratory arrest and death. 

Side Effects Of Mixing Xanax And Klonopin

Klonopin and Xanax are both highly-potent benzodiazepine drugs used to treat Anxiety and panic disorder. No matter how efficacious these drugs are, they cause some or other side effects. If any of the below-listed side effects develop, seek advice from a healthcare professional.

Klonopin Side Effects Xanax Side Effects
Drowsiness Forgetfulness or difficulty concentrating,
Dizziness Changes in appetite
Shaky movements and unsteady gait Drowsiness and fatigue
Depression Lightheadedness
Memory problems Sexual dysfunction
Fatigue Joint pain
Constipation or Diarrhea Dry mouth

As Klonopin and Xanax cause poor coordination and drowsiness, people taking these medicines should be cautious while operating machinery or driving. With either medication, a severe allergic reaction is unlikely to occur. However, if an individual develops symptoms such as difficulty breathing, rash, swelling, or itching— they need emergency help.

Dangers Of Mixing Xanax And Klonopin

When Klonopin and Xanax are abused individually, risks are involved. However, when these high-potency benzodiazepines are used together, the risks, including overdose and addiction, are heightened to another level.

Xanax and Klonopin are benzodiazepine sedative drugs. During drug abuse, their side effect can be pronounced, leading to reduced blood pressure, heart, breathing, and temperature rates. In most serious cases, an individual could faint, develop severe respiratory depression, lead to a coma, and even be fatal.

Xanax has a short half-life, which indicates that the effects will be observed more rapidly and for a shorter period. On the other hand, Klonopin has a longer half-life leading to results for high and more extended periods.

The order by which these medications are taken can influence the danger an individual faces. Taking these medicines in any order is anyhow dangerous. Individuals will be more inclined to Abuse these two medications if they first take one with a long-acting form. For instance, if an individual takes Klonopin first, he might not feel the effect as quickly as they wish to. This may lead some people to take a higher dose of Xanax.

Due to its long half-life, Klonopin remains in a person's system for longer than they may have intended or realized. Even though the high dosage may have washed off, the drug can still be present.

Xanax lasts for only a few hours, while Klonopin last three times longer than that. With this understanding, Klonopin becomes the stronger of the two prescription drugs.
Klonopin is more addictive than Xanax. This is because Klonopin produces a greater feeling of euphoria. The more your brain experiences this feeling, the more you want to feel it repeatedly.
According to the benzodiazepine equivalency table, 0.5mg of Xanax (Alprazolam) is approximately equivalent to 0.5mg of Klonopin (Clonazepam).

Short-Term Risks And Dangers Of Mixing Xanax And Klonopin

To completely understand the effects of polydrug benzodiazepine abuse, it is essential to know the overall risks associated with benzodiazepine Abuse. Even in the short term, abusing a benzodiazepine drug like Klonopin or Xanax can affect both physically and mentally. The short-term risks of mixing Xanax and Klonopin include:

  • Gastrointestinal distress (nausea, vomiting, constipation, or diarrhea)
  • Abdominal pain
  • Confusion
  • Depression
  • Slurred speech or stuttering
  • Drowsiness
  • Fatigue
  • Vision changes
  • Respiratory depression
  • Tremors 

Combining Klonopin and Xanax can increase the seriousness of the side effects, sometimes to a greater extent. Because Xanax (Alprazolam) is more toxic than other benzodiazepine sedatives, combining it with other benzo drugs like Klonopin increases the chances of a severe overdose.

Benzodiazepine abuse can cause paradoxical disinhibition, which produces impulsivity, aggression, hostility, and in more limited cases, rage or acts of violence. These risks are more pronounced in the elderly and persons with developmental disabilities. Elderly persons also face an increased risk of hip and femur fractures from falls while abusing these drugs.

Long-Term Risks And Dangers Of Mixing Xanax And Klonopin

Abusing a drug for a prolonged period or in larger dosages can cause tolerance and dependence, two factors pushing an individual toward addiction. 

Once an individual becomes dependent on a benzo, they often fall into the trap of taking repeated doses to avoid withdrawal, which can quickly escalate into the compulsive patterns of addiction.

When alcohol is taken with Xanax and Klonopin, a person is at a more significant risk of overdose. Chronic and abusive use of drugs in this category can cause cognitive deficits. They may have difficulty speaking. Memory impairment can develop. These drugs, in combination, have the potential to cause brain damage. Additional risks of long-term benzodiazepine abuse include:

  • Increased risk of dementia and Alzheimer's, as reported by Harvard Health Publishing.
  • Depression and suicidal ideation (thoughts of suicide).
  • Numbed emotional state or "emotional anesthesia."
  • Mothers who give birth to benzodiazepine-dependent babies experience withdrawal.
  • Impulsive behavior and mood swings

People addicted to combining Klonopin with Xanax may experience sleep disturbances once they stop taking the drugs. They may suffer from depression, Anxiety, tension, irritability, panic attacks, mood swings, and psychosis.

Chronic abuse of Xanax and Klonopin can cause severe damage to an individual's life—a person's relationships, whether family or close friends, frequently suffer. In the most severe cases, marriages and demanding situations at houses or jobs may end due to the behavioral and financial impacts of addictive behaviors.

Overdose Risk When Mixing Xanax and Klonopin

Benzodiazepines have a lower risk of overdose compared to other prescription drugs. Even in higher doses, triggering an overdose is not likely. Taking high doses of two benzos at once can increase your risk of overdose, compared to taking one as directed. People who overdose on these medications may become suddenly responsive.

Xanax overdose is expected in the United States. Dangerous side effects, including hypotension, coma, and death, may result when mixing Klonopin and Xanax. People who overdose on either of the medications (Klonopin and Xanax) may experience the following symptoms:

  • Hypotension
  • Respiratory depression
  • Poor coordination
  • Drowsiness
  • Blurred vision
  • Confusion
  • Coma
  • Death

Doctors usually prescribe the lowest possible dose of benzodiazepines for short durations only to avoid risks of addiction, chemical dependency, and overdose. The withdrawal from these medications can be life-threatening.

Xanax And Klonopin Drug Interactions

Tell your prescribing doctor, pharmacist, or nurse practitioner about any other medicines (prescription/ non-prescription/ OTC drugs) or supplements you might be taking to determine if Xanax or Klonopin have any interactions with them, as it can lead to adverse reactions.

Xanax Interaction:

Xanax interacts with alcohol and medications that decrease activity in the brain and cause sedation (e.g., barbiturates and narcotics). Cimetidine, Ketoconazole, Fluvoxamine, Nefazodone, and Itraconazole increase concentrations in the blood of Xanax and may increase its side effects. Rifampin and Carbamazepine reduce the impact of Xanax by increasing its metabolism and elimination in the liver.

Klonopin Interaction:

Klonopin reduces the levels of Carbamazepine. It might affect the levels of Phenytoin (diphenylhydantoin). In turn, Phenytoin may reduce plasma levels of Clonazepam by increasing the speed of Clonazepam clearance by nearly 50% and decreasing its half-life by 31 %. Klonopin increases the levels of Phenobarbital and Primidone. Cannabidiol, a drug with anticonvulsant properties, reduces the anticonvulsant protency of Klonopin.

Benzodiazepines, including Klonopin, might inhibit the glucuronidation of morphine, leading to increased levels and prolonged effects of morphine. Clonazepam can inhibit morphine metabolism more than any other benzodiazepine.

Bottom Line From Practical Anxiety Solutions

Klonopin and Xanax are the best choices for treating Anxiety. Klonopin is valuable for longer duration and lower potential for abuse, while Xanax is valuable for how quickly it works. Individually and when used correctly, both medicines are safe for short-term use (or long-term use if deemed necessary).

When used in combination with each other or with alcohol, neither are safe. The potential of abuse for benzodiazepines is high, and the outcomes are dangerous, if not deadly. Seek guidance from a pharmacist or medical practitioner about avoiding or managing the risks if you are considering taking these drugs in tandem.

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