Alcohol Withdrawal and Anxiety Disorders
Oxazepam shares the actions of other benzodiazepines and is used for the management of agitation associated with acute alcohol withdrawal and for the management of anxiety disorders or for the short-term relief of symptoms of anxiety or anxiety associated with depressive symptoms. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic. The efficacy of oxazepam for long-term use (i.e., longer than 4 months) has not been evaluated. The need for continued therapy with the drug should be periodically reassessed.
Administration 
Oxazepam is administered orally in divided doses.
Dosage
Dosage of oxazepam must be individualized, and the smallest effective dosage should be used (especially in geriatric or debilitated patients and in those with low serum albumin) to avoid oversedation.
For the symptomatic treatment of mild to moderate anxiety, the usual adult dosage of oxazepam is 10-15 mg 3 or 4 times daily. For severe anxiety or the management of agitation associated with acute alcohol withdrawal, 15-30 mg may be given 3 or 4 times daily. In geriatric patients, oxazepam therapy should be initiated with 10 mg 3 times daily and increased to 15 mg 3 or 4 times daily, if necessary. In patients who have received prolonged (e.g., for several months) oxazepam therapy, abrupt discontinuance of the drug should be avoided since manifestations of withdrawal can be precipitated; if the drug is to be discontinued in such patients, it is recommended that dosage be gradually tapered.
Dosage of oxazepam for children 6-12 years of age has not been clearly established.
Precautions and Contraindications
A boxed warning has been included in the prescribing information for all benzodiazepines describing the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions associated with all drugs in this class.900 Abuse and misuse can result in overdose or death, especially when benzodiazepines are combined with other medicines, such as opioid pain relievers, alcohol, or illicit drugs.900 Frequent follow-up with patients receiving benzodiazepines is important.900 Reassess patients regularly to manage their medical conditions and any withdrawal symptoms.900 Clinicians should assess a patient's risk of abuse, misuse, and addiction. 900 Standardized screening tools are available ([Web]).900 To reduce the risk of acute withdrawal reactions, use a gradual dose taper when reducing the dosage or discontinuing benzodiazepines.900 Take precautions when benzodiazepines are used in combination with opioid medications.900
Oxazepam shares the toxic potentials of the benzodiazepines, and the usual precautions of benzodiazepine administration should be observed. (See Cautions in the Benzodiazepines General Statement 28:24.08.)
Pediatric Precautions
Safety and efficacy of oxazepam in children younger than 6 years of age have not been established.
Chemistry and Stability
Chemistry
Oxazepam is a benzodiazepine. Oxazepam occurs as a creamy white or pale yellow powder. The drug is practically insoluble in water and slightly soluble in alcohol. Oxazepam has pKas of 1.7 and 11.6.
Stability
Oxazepam capsules should be stored in well-closed containers at a temperature less than 40°C, preferably at 15-30°C.
Additional Information
For further information on chemistry, pharmacology, pharmacokinetics, uses, cautions, chronic toxicity, acute toxicity, drug interactions, laboratory test interferences, and dosage and administration of oxazepam, see the Benzodiazepines General Statement 28:24.08.
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
Subject to control under the Federal Controlled Substances Act of 1970 as a schedule IV (C-IV) drug.
Oxazepam
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|
Oral | Capsules | 10 mg* | Oxazepam Capsules (C-IV) | |
| | 15 mg* | Oxazepam Capsules (C-IV) | |
| | 30 mg* | Oxazepam Capsules (C-IV) | |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
AHFS® Drug Information. © Copyright, 1959-2024, Selected Revisions September 26, 2022. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, MD 20814.
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