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Pregnancy Category: D
ClassificationTherapeutic: antianxiety agents
Management of anxiety, anxiety associated with depression.Symptomatic treatment of alcohol withdrawal.
Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter.
Diminished symptoms of alcohol withdrawal.
Absorption: Well absorbed following oral administration. Absorption is slower than with other benzodiazepines.
Distribution: Widely distributed. Crosses the blood-brain barrier. May cross the placenta and enter breast milk.
Metabolism and Excretion: Metabolized by the liver to inactive compounds.
Protein Binding: 97%.
Half-life: 5–15 hr.
Time/action profile (sedation)
|PO||45–90 min||unknown||6–12 hr|
Contraindicated in: Hypersensitivity;Cross-sensitivity with other benzodiazepines may exist;Comatose patients or those with pre-existing CNS depression;Uncontrolled severe pain;Angle-closure glaucoma;Some products contain tartrazine and should be avoided in patients with known intolerance; Obstetric / Lactation: Pregnancy or lactation.
Use Cautiously in: Hepatic dysfunction (may be preferred over some benzodiazepines due to short half-life);History of suicide attempt or substance use disorder;Debilitated patients (initial dosage ↓ recommended);Severe chronic obstructive pulmonary disease;Myasthenia gravis; Pediatric: Children <6 yr (safety not established); Geriatric: Appears on Beers list (associated with ↑ risk of falls; ↓ dose required); ↑sensitivity to benzodiazepines.
Adverse Reactions/Side Effects
Central nervous system
- dizziness (most frequent)
- drowsiness (most frequent)
- impaired memory
- mental depression
- paradoxical excitation
- slurred speech
Ear, Eye, Nose, Throat
- blurred vision
- respiratory depression
- drug-induced hepatitis
- weight gain (unusual)
- urinary problems
- physical dependence
- psychological dependence
Drug-Drug interactionAdditive CNS depression with other CNS depressants, including alcohol, antihistamines, antidepressants, opioid analgesics, and other sedative/hypnotics (including other benzodiazepines ).May ↓ the therapeutic effectiveness of levodopa.Hormonal contraceptives or phenytoin may ↓ effectiveness.Theophylline may ↓ sedative effects.Concomitant use of kava-kava, valerian, skullcap, chamomile, or hops can ↑ CNS depression.
Oral (Adults) Antianxiety agent—10–30 mg 3–4 times daily. Sedative/hypnotic/management of alcohol withdrawal—15–30 mg 3–4 times daily.
Oral (Geriatric Patients) 5 mg 1–2 times daily initially or 10 mg 3 times daily; may be ↑ as needed.
Availability (generic available)
Capsules: 10 mg, 15 mg, 30 mg
Tablets: 10 mg, 15 mg, 30 mg
- Assess patient for anxiety and orientation, mood and behavior.
- Assess level of sedation (ataxia, dizziness, slurred speech) periodically throughout therapy.
- Assess regularly for continued need for treatment.
- Prolonged high-dose therapy may lead to psychological or physical dependence. Restrict the amount of drug available to patient.
- Geriatric: Assess CNS effects and risk of falls. Institute falls prevention strategies.
- Lab Test Considerations: Monitor CBC and liver function tests periodically during prolonged therapy.
- May cause decreased thyroidal uptake of sodium iodide 123I and 131I.
Potential Nursing DiagnosesAnxiety (Indications)
Ineffective coping (Indications)
Risk for injury (Side Effects)
- Medication should be tapered at the completion of therapy (taper by 0.5 mg q 3 days). Sudden cessation of medication may lead to withdrawal (insomnia, irritability, nervousness, tremors).
- Oral: Administer with food if GI irritation becomes a problem.
- Instruct patient to take oxazepam exactly as directed. Missed doses should be taken within 1 hr; if remembered later, omit and return to regular dosing schedule. Do not double or increase doses. If dose is less effective after a few weeks, notify health care professional.
- Inform patient that oxazepam is usually prescribed for short-term use. Encourage patient to participate in psychotherapy to address source of anxiety and improve coping skills.
- Encourage patient to participate in psychotherapy to address source of anxiety and improve coping skills.
- Teach other methods to decrease anxiety, such as increased exercise, support group, relaxation techniques.
- May cause drowsiness or dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
- Advise patient to avoid the use of alcohol and to consult health care professional prior to the use of OTC preparations that contain antihistamines or alcohol.
- Advise patient to notify health care professional of medication regimen prior to treatment or surgery.
- Advise patient to inform health care professional if pregnancy is planned or suspected.
- Emphasize the importance of follow-up exams to monitor effectiveness of medication.
- Geriatric: Instruct patient and family how to reduce falls risk at home.
- Decreased sense of anxiety.
- Increased ability to cope.
- Prevention or relief of acute agitation, tremor, and hallucinations during alcohol withdrawal.