Ensuring Accurate Medication Dosage: A Nurse’s Guide for Alprazolam (Xanax) Administration

Accurate medication dosage is essential to ensure that patients receive the intended therapeutic effect. In this article, we will discuss how a nurse can navigate a situation where a pharmacy has mistakenly dispensed Xanax 0.25 mg tablets instead of the prescribed 0.5 mg for a 45-year-old female patient with an anxiety disorder. The nurse’s responsibility is to administer the correct dose of 0.5 mg, but the tablets on hand are 0.25 mg each.

Understanding Anxiety Disorder

Anxiety disorder is a common mental health condition that can lead to excessive worry, fear, and anxiety. Medications like alprazolam (Xanax) are often prescribed to manage the symptoms of anxiety disorders. Ensuring patients receive the correct dosage is critical for their well-being and effective treatment.

Administering the Correct Dose of Alprazolam

To administer the correct dose of 0.5 mg of alprazolam (Xanax) when the available tablets are 0.25 mg each, the nurse should follow these steps:

Step 1: Calculate the Change in Dosage

Start by determining the change in dosage required. In this case, the patient needs 0.5 mg, but the available tablets are only 0.25 mg.

Change in dosage = New dosage – Current dosage

Change in dosage = 0.5 mg – 0.25 mg

Change in dosage = 0.25 mg

Step 2: Identify the Number of 0.25 mg Tablets Required

To find out how many 0.25 mg tablets are needed to achieve the change in dosage, divide the change in dosage by the strength of each tablet.

Tablets required = Change in dosage / Tablet strength

Tablets required = 0.25 mg / 0.25 mg/tablet

Tablets required = 1 tablet

The nurse should give the patient 1 tablet of Xanax 0.25 mg to achieve the prescribed dosage of 0.5 mg.

Step 3: Patient Education

It’s essential to educate the patient about the medication change. Ensure the patient understands the new dosing regimen, the importance of adherence, and any potential side effects or differences in the experience of the medication.

Confirming the Prescription

Before proceeding, the nurse should double-check the prescription to verify that it indeed should be changed to 0.5 mg and that the change is not an error. If there are any concerns or discrepancies, it’s important to contact the prescribing healthcare provider for clarification.

Patient Safety and Monitoring

Once the patient has taken the medication, it’s crucial to monitor for any signs of effectiveness or adverse reactions. The nurse should document the medication administration and the patient’s response to the new dosage. Additionally, ongoing communication with the patient about their anxiety symptoms and overall well-being is essential for effective treatment.


Ensuring accurate medication dosage is a fundamental responsibility of healthcare professionals, particularly for patients with conditions like anxiety disorder. In this case, administering the correct dose of alprazolam (Xanax) for a 45-year-old female patient with anxiety disorder involves providing 1 tablet of Xanax 0.25 mg when the prescribed dose is 0.5 mg. Patient education, safety, and monitoring are integral components of the process, aiming to improve the patient’s quality of life and manage their anxiety effectively.


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