Oxazepam (Oral)

Oxazepam, marketed under the brand name of Serax, is a benzodiazepine drug used to treat anxiety and irritability as well as being used as an aid in helping people who are withdrawing from dependence on alcohol.

Overview

Oxazepam is sold on the consumer market under the brand name of Serax. Oxazepam is a part of a class of drugs known as benzodiazepines. This class of drug is most commonly used to treat a number of conditions that are referred to as anxiety disorders. The drug is used to treat these disorders on their own, and the drug is used to treat anxiety that is associated with various types of depression. In addition to these uses, oxazepam is also used to reduce irritability in patients that are withdrawing from dependence on alcohol. Sometimes, the drug is also used with patients who have irritable bowel syndrome that is associated with emotional upset or anxiety. Oxazepam is also used to treat other conditions that include insomnia, tension and agitation. Oxazepam is not appropriate to treat the type of anxiety that most people experience as a result of everyday life. The drug is designed for short-term use only. Generally, the drug is not to be used for a period of more than four months unless absolutely necessary.

In order to help those with anxiety, oxazepam is designed to act on the GABA receptors in the human brain. When the drug acts on the brain's GABA receptors it causes cortisol to be inhibited. Cortisol is released in the body causing arousal. When this is blocked or inhibited, the patient is not placed in an anxious state. Also, when the GABA receptors are stimulated, it helps the body block the arousal of the limbic system when it is stimulated by thoughts or events that might produce an anxious response in a patient.

Oxazepam also works to slow down the activity in the brain. As brain activity becomes slower, it allows the entire body to be placed in a more relaxed state so that panic attacks and other symptoms of anxiety disorders are limited.

Oxazepam and other benzodiazepines are schedule IV drugs. They are considered to be addictive if used over a period of time or in large doses. Patients, and the dosages given to them, must be carefully monitored so that the patients do not develop a dependency on the drug. Oxazepam should not be used in conjunction with other drugs in this class such as Valium. Those who have demonstrated addiction to other benzodiazepines and other anti-anxiety drugs should not be prescribed this drug.

Great caution should be exercised if patients are given this drug along with opioid class drugs such as oxycodone, hydrocodone and morphine. Opioid drugs and benzodiazepines can cause a patient to be placed in a state of deep sedation. This state of deep sedation may lead to difficulty in breathing and breathing obstruction which can result in a patient's death. Taking oxazepam with opioids can also lead to coma if too much of either drug is used.

Patients should be highly cautioned regarding using oxazepam with alcohol. Using alcohol along with oxazepam can lead to deep sedation, breathing difficulties and possibly death.

There are a number of side effects that are common among patients that are using this drug. Some of the more common side effects include dizziness, drowsiness and blurred vision. Some people who use this drug have reported difficulty in keeping their balance along with tremors and shaking. Several other side effects have been reported with the use of oxazepam.

Drugs in the same class as oxazepam are known to cause birth defects in infants if the drugs are used during the first trimester. Women who are pregnant or who are planning to become pregnant should not use oxazepam. Women of childbearing age should take precautions against becoming pregnant while using this drug.

Conditions Treated

  • Generalized Anxiety Disorder

Type of Drug:

  • Anti-anxiety drug in the benzodiazepine class of drugs.

Side Effects

Almost all of the side effects reported with the use of oxazepam are mild in nature. In most instances, the drug does not have to be discontinued. Some patients will develop an allergic reaction to the ingredients in the drug. If a patient takes the drug and reports breathing difficulties, severe skin reactions or swelling of the eyes or lips, the physician should be contacted immediately, and the drug should be discontinued. If a patient has had an allergic reaction to other drugs in the benzodiazepine family, use of oxazepam should be avoided.

The most common side effects associated with oxazepam only occur in about one percent of patients. Drowsiness is the most common side effect. This is due to the way in which the drug acts on the brain. Another of the more common side effects is dizziness. This is usually mild. This dizziness may manifest itself as vertigo where the patient feels as if objects in the room or the room itself is spinning around. Dizziness may also manifest itself as a loss of balance.

Side effects known as paradoxical reactions have occurred in some patients. These are reactions that are opposite of the condition the drug is intended to treat. For instance, some patients report that they become more tense and more anxious when they use the drug. This type of side effect typically only occurs within the first 14 days of the drug being used.

There have been some reports of nausea with those using oxazepam. This is usually mild. Some have reported abdominal pain and black stools while using the drug.

A few urinary side effects have been reported. Patients have reported dark urine while on the drug. Some patients have difficulty urinating and others report painful and difficult urination.

One set of rare but serious side effects has been reported. Liver side effects have been reported that include hepatic dysfunction leading to jaundice. Because of this occurrence, doctors should use periodic blood tests to check the patients liver functions to make sure that liver damage or disruption is not occurring.

The following side effects have been noted with the use of oxazepam, but they are rare:

  • Chest pain

While not normally seen in patients who are taking oxazepam, some serious side effects have been noted in patients taking other anti-anxiety drugs in the benzodiazepine family. Agranulocytosis, abnormal EEG patterns, outbursts of rage and amnesia have all been reported.

Any side effects or potential side effects should be reported to the prescribing physician.

Dosage

The dosage of oxazepam that the patient receives is dependent on the condition for which the patient is being treated.

For managing the symptoms of mild to moderate anxiety, the dosage usually given to adult patients is 10 to 15 milligrams given three to four times per day. Patients who have severe anxiety disorders are given a dosage of 15 to 30 milligrams three to four times per day. Those who have anxiety associated with depression are also given this dosage of medication as are those who are taking the drug to aid with the symptoms of withdrawing from alcohol dependency.

Geriatric patients are given a lower dosage of oxazepam. They normally only receive 10 milligrams of the drug three times each day. This dose may be increased to 15 milligrams three to four times a day if absolutely necessary.

Those children who are over the age of 13 are usually put on the same dosage regimen as adults. This drug is not recommended for children under the age of 13. Testing for a dosage level in these patients has not been carried out.

Interactions

Oxazepam has interactions with a number of different drugs. It should not be used at the same time as other drugs in benzodiazepine family. It should also not be used at the same time as opioid drugs. Oxazepam should not be used with the drug flumazenil. The use of valerian and oxazepam can have serious consequences.

The following drugs may interact with oxazepam, and patients on these drugs should be monitored:

  • Albuterol
  • Alfentanil
  • Alprazolam
  • Amisulpride
  • Amitriptyline
  • Amobarbital
  • Amoxapine
  • Apomorphine
  • Arformoterol
  • Aripiprazole
  • Armodafinil
  • Azelastine
  • Baclofen
  • Bambuterol
  • Belladonna and opium
  • Benperidol
  • Benzphetamine
  • Brompheniramine
  • Buprenorphine
  • Buprenorphine buccal
  • Buprenorphine subdermal implant
  • Buprenorphine, long-acting injection
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Caffeine
  • Carbinoxamine
  • Carisoprodol
  • Chloral hydrate
  • Chlordiazepoxide
  • Chlorpheniramine
  • Chlorpromazine
  • Chlorzoxazone
  • Cinnarizine
  • Clemastine
  • Clobazam
  • Clomethiazole
  • Clomipramine
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Codeine
  • Cyclizine
  • Cyclobenzaprine
  • Cyproheptadine
  • Dantrolene
  • Desflurane
  • Desipramine
  • Deutetrabenazine
  • Dexchlorpheniramine
  • Dexfenfluramine
  • Dexmedetomidine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromoramide
  • Diamorphine
  • Diazepam
  • Diethylpropion
  • Difenoxin hcl
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenoxylate hcl
  • Dipipanone
  • Dobutamine
  • Dopamine
  • Dopexamine
  • Dosulepin
  • Doxepin
  • Doxylamine
  • Droperidol
  • Enflurane
  • Ephedrine
  • Ephedrine (pulmonary)
  • Epinephrine
  • Epinephrine racemic
  • Estazolam
  • Ethanol
  • Etomidate
  • Fenfluramine
  • Flibanserin
  • Fluphenazine
  • Flurazepam
  • Formoterol
  • Fospropofol
  • Haloperidol
  • Hexobarbital
  • Hyaluronidase
  • Hydromorphone
  • Hydroxyzine
  • Iloperidone
  • Imipramine
  • Isoproterenol
  • Ketamine
  • Ketotifen, ophthalmic
  • Levalbuterol
  • Levorphanol
  • Lisdexamfetamine
  • Lofepramine
  • Lofexidine
  • Loprazolam
  • Lorazepam
  • Lormetazepam
  • Loxapine
  • Loxapine inhaled
  • Lurasidone
  • Maprotiline
  • Marijuana
  • Melatonin
  • Meperidine
  • Mephobarbital
  • Meprobamate
  • Metaproterenol
  • Metaxalone
  • Methadone
  • Methamphetamine
  • Methocarbamol
  • Methylenedioxymethamphetamine
  • Methylphenidate
  • Mianserin
  • Midazolam
  • Midodrine
  • Mirtazapine
  • Modafinil
  • Morphine
  • Motherwort
  • Moxonidine
  • Nabilone
  • Nalbuphine
  • Norepinephrine
  • Nortriptyline
  • Olanzapine
  • Opium tincture
  • Orphenadrine
  • Oxycodone
  • Oxymorphone
  • Paliperidone
  • Papaveretum
  • Papaverine
  • Pentazocine
  • Pentobarbital
  • Perampanel
  • Perphenazine
  • Phendimetrazine
  • Phenobarbital
  • Phentermine
  • Phenylephrine
  • Phenylephrine po
  • Pholcodine
  • Pimozide
  • Pirbuterol
  • Primidone
  • Prochlorperazine
  • Promethazine
  • Propofol
  • Propylhexedrine
  • Protriptyline
  • Pseudoephedrine
  • Quazepam
  • Quetiapine
  • Ramelteon
  • Risperidone
  • Salmeterol
  • Scullcap
  • Secobarbital
  • Sertindole
  • Sevoflurane
  • Shepherd's purse
  • Sufentanil
  • Sulpiride
  • Suvorexant
  • Tapentadol
  • Teduglutide
  • Temazepam
  • Terbutaline
  • Terfenadine
  • Thioridazine
  • Thiothixene
  • Topiramate
  • Tramadol
  • Trazodone
  • Triazolam
  • Triclofos
  • Trifluoperazine
  • Trimipramine
  • Triprolidine
  • Xylometazoline
  • Yohimbine
  • Ziconotide
  • Ziprasidone
  • Zotepine
  • Patients on the following drugs may have an interaction in some instances, but most patients will not:
  • Brimonidine
  • Eucalyptus
  • Fleroxacin
  • Gemifloxacin
  • Green tea
  • Labetalol
  • Levofloxacin
  • Metoprolol
  • Moxifloxacin
  • Norfloxacin
  • Ofloxacin
  • Propranolol
  • Rifabutin
  • Sage
  • Vinpocetine
  • Zolpidem

Warnings

Oxazepam is a drug that may be habit forming and addictive. Patients are cautioned to not take the drug in dosages that are higher than what have been prescribed by the healthcare provider. Long-term use of the drug is more likely to result in addiction.

Oxazepam is not intended to be used for the long-term treatment of anxiety disorders. The drug is intended for use for a period that does not exceed four months. If a patient has not responded within that period, the patient should be reassessed for additional treatment.

This drug should not be taken along with opioid class drugs such as oxycodone and hydrocodone. Both of these types of drugs suppress the central nervous system. If both oxazepam and opioids are taken together, especially in high doses of one drug or the other, the central nervous system may be too greatly suppressed. This can result in deep sedation that leads to breathing difficulties and cessation of breathing. Some patients may fall into a coma if oxazepam and opioids are used together.

All benzodiazepine drugs are believed to cause congenital birth defects in children when they are taken in the first trimester of pregnancy. Women who are pregnant, think they might be pregnant or plan to become pregnant while on the drug should not take oxazepam. Women of childbearing years should use measures to prevent pregnancy while on the drug.

This drug should be used with caution in geriatric patients and in patients with kidney function difficulties. The dosage of the drug will need to be adjusted in these patients.

Patients with glaucoma, kidney disease and liver disease should notify their doctor before starting this medication.

Storage

The drug should be stored at room temperature. It should be kept out of reach of children and pets in a sealed container.

When treatment is finished, leftover medication should be disposed of carefully, ideally through a drug take-back program.

Summary

Oxazepam is a drug that is used to treat anxiety disorders and anxiety that occurs along with depression. It is also used to aid in the treatment of those who are withdrawing from alcohol dependency. People with insomnia and irritable bowel symptoms are also sometimes prescribed this drug.

This drug has a number of side effects. Almost all of the side effects are rare, and the side effects that do occur are usually mild in nature and do not require that the drug be discontinued.

Several drugs interact with oxazepam. Patients should tell their doctor about any medications that they are currently taking whether they are prescription or nonprescription drugs.

The dosage of oxazepam given to a patient depends on the severity of the condition for which the drug is being prescribed. Geriatric patients should receive a lower dosage of the drug. The drug is normally not given to children under the age of 12.