Oxazepam

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Definition

Oxazepam is a member of a family of tranquilizers known as benzodiazepines. It is sold in the United States under the brand name Serax and in Canada under the brand name Ox-Pam. Generic forms of oxazepam are also available.

Purpose

Oxazepam is prescribed to treat feelings of tension and anxiety. It is also used to calm patients who are suffering from the symptoms of alcohol withdrawal.

Description

Oxazepam is one of several drugs in the class called benzodiazepines. Oxazepam slows down certain brain functions by blocking specific chemicals that transmit messages among the nerve cells in the brain.

Recommended dosage

The typical starting dose for adults ranges from 5–15 mg per day. The dosage is sometimes increased by the doctor, but 80 mg is usually the maximum amount prescribed per day. The amount used each day is typically divided into at least two doses. Oxazepam is taken by mouth, and is available in tablets and capsules. It can be taken with food if the patient is having side effects in the digestive tract.

Oxazepam is not FDA-approved for use in children under six years. However, often in clinical practice, the medication is used with close physician supervision. The typical starting dose for children aged two to 16 years is 5 mg. The doctor may increase this dose if necessary. Typically, the dose does not exceed 40 mg per day, and is given in divided doses. Children under two years of age may receive a dose based on body weight. The doctor must determine whether the child needs the drug as well as the dosage.

Precautions

The doctor should monitor the patient at regular intervals to ensure that the medicine is not causing troublesome side effects. Monitoring the patient is particularly important if the drug is being taken over a long period of time. Patients should not stop taking oxazepam suddenly, especially if they are taking large doses. The dose should be tapered (gradually decreased), and then stopped. Suddenly discontinuing oxazepam may cause a rebound effect. In a few cases patients have reported serious withdrawal symptoms when they stopped taking oxazepam, including nausea, vomiting, muscle cramps, and unusual irritability.

Oxazepam should be given with great care to elderly patients; to people who are significantly disabled; and to people with a history of liver or kidney disease, drug abuse, or breathing problems. Pregnant women should not take oxazepam because of the risk of birth defects in the baby. Likewise, nursing mothers should not use oxazepam while they breast-feed. Oxazepam and other benzodiazepines should never be combined with alcohol or other drugs that depress (lower the activity of) the central nervous system. Oxazepam and other benzodiazepines should be prescribed and used very carefully if they are given for long-term treatment because they are habit-forming. Patients who have been diagnosed with glaucoma or serious psychological disorders should not receive oxazepam. Patients who have a history of alcohol abuse, drug abuse, brain disease, mental depression, mental illness, sleep apnea, or myasthenia gravis should tell their doctor about their condition. Similarly, a woman who becomes pregnant while she is taking the drug should tell her doctor at once.

Side effects

Rare but serious side effects associated with the use of oxazepam include: anxiety, mental depression, reduced memory, and confusion. Even more rare are disorientation, delusions , seizures , unusually low blood pressure, sleeping difficulties, muscle weakness, and changes in behavior.

Less serious but more common side effects include: difficulty talking, dizziness, clumsiness, and drowsiness. Less common but not particularly serious side effects include dry mouth, general weakness, headache, mild abdominal pain, constipation, diarrhea, nausea, and vomiting.

When the patient stops taking oxazepam, nervousness, irritability, and sleeping problems are common withdrawal side effects. Less common withdrawal side effects can include confusion, hearing problems, stomach cramps, increased sweating, mental depression, nausea, and vomiting. Rare withdrawal side effects can include seizures, hallucinations , and paranoid ideas.

Interactions

Patients should always inform every health professional that they deal with— doctors, pharmacists, nurses, dentists, and others— about every medication they take. Oxazepam, alcohol, and other medications that cause drowsiness can intensify one another's effects. Some medications that are used to treat viral infections, fungal infections, high blood pressure, and some heart rhythm problems can increase the effects of oxazepam.

Heavy smoking decreases the effectiveness of oxazepam.

Resources

BOOKS

Consumer Reports Staff, eds. Consumer Reports Complete Drug Reference. 2002 ed. Denver, CO: Micromedex Thomson Healthcare, 2001.

Ellsworth, Allan J. and others. Mosby's Medical Drug Reference. 2001-2002. St. Louis, MO: Mosby, 2001.

Hardman, Joel G., Lee E. Limbird, ed. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw-Hill, 2001.

Mosby's GenRx Staff. Mosby's GenRx. 9th ed. St. Louis, MO: Mosby, 1999.

Venes, Donald, and others, eds. Taber's Cyclopedic Medical Dictionary. 19th ed. Philadelphia, PA: F. A. Davis, 2001.

Mark Mitchell, M.D.