Generally, alprazolam is safe for the heart when taken exactly as prescribed. Since it calms the central nervous system, it can actually help lower a rapid heart rate and high blood pressure caused by anxiety or panic attacks. However, it is not a direct heart medication. It can become dangerous if misused, taken in overdose, or mixed with alcohol or opioids, which can dangerously slow your heart rate and breathing. Additionally, abruptly stopping alprazolam can cause withdrawal symptoms like a rapid heart rate and spiked blood pressure. Always consult your doctor before starting or stopping this medication, especially if you have pre-existing heart conditions.