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Pharmacologic class: Benzodiazepine
Therapeutic class: Anxiolytic, sedative-hypnotic
Controlled substance schedule IV
Pregnancy risk category D
Suppresses CNS stimulation at limbic and subcortical levels by potentiating effects of gamma-aminobutyrate, an inhibitory neurotransmitter. This suppression reduces anxiety and diminishes alcohol withdrawal symptoms.
Capsules: 10 mg, 15 mg, 30 mg
Tablets: 15 mg
Indications and dosages
➣ Mild to moderate anxiety
Adults: 10 to 15 mg P.O. three to four times daily
➣ Severe anxiety; alcohol withdrawal symptoms
Adults: 15 to 30 mg P.O. three to four times daily
• Elderly patients
• Hypersensitivity to drug or tartrazine (some products)
Use cautiously in:
• hepatic dysfunction, severe chronic obstructive pulmonary disease, myasthenia gravis, CNS depression, uncontrolled severe pain
• history of suicide attempt or drug abuse
• concurrent use of other benzodiazepines
• elderly or debilitated patients
• pregnant or breastfeeding patients.
• Administer with or without food.
• Taper dosage after long-term therapy.
CNS: dizziness, drowsiness, headache, confusion, poor memory, hangover effect, slurred speech, depression, paradoxical stimulation
CV: orthostatic hypotension, hypotension, ECG changes, tachycardia
EENT: blurred vision, mydriasis, tinnitus
GI: nausea, vomiting, constipation, diarrhea
GU: urinary retention, urinary incontinence
Hepatic: jaundice, hepatitis
Respiratory: respiratory depression
Skin: rash, dermatitis, itching
Other: physical and psychological drug dependence, drug tolerance, withdrawal symptoms
Drug-drug. Azole antifungals: increased oxazepam blood level, greater risk of toxicity
Hormonal contraceptives, phenytoin: decreased oxazepam efficacy
Levodopa: decreased levodopa efficacy
Other CNS depressants (including anti-depressants, antihistamines, other benzodiazepines, sedative-hypnotics, opioids): additive CNS depression
Theophylline: decreased sedative effect of oxazepam
Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase: increased levels
Hematocrit, thyroid uptake of sodium iodide 123I and131I, white blood cells: decreased values
Drug-food. Cabbage: decreased drug blood level
Drug-herbs. Chamomile, hops, kava, valerian, skullcap: increased CNS depression
Drug-behaviors. Alcohol use: increased CNS depression
☞ Monitor liver function tests and watch for signs and symptoms of hepatitis.
• Check vital signs. Stay alert for respiratory depression, orthostatic hypotension, and tachycardia.
• Monitor neurologic status. As needed, take measures to prevent injury.
• Watch for signs and symptoms of psychological or physical dependence.
• When tapering, watch for withdrawal symptoms.
• Tell patient he may take with or without meals, but should avoid cabbage.
• Advise patient to take exactly as prescribed. Tell him drug can cause dependence, and emphasize importance of following tapering instructions to avoid withdrawal symptoms.
☞ Urge patient to immediately report unusual tiredness, nausea, appetite loss, or yellowing of skin or eyes.
• Tell patient to change position slowly to avoid blood pressure decrease.
• Instruct patient to report severe dizziness, weakness, persistent drowsiness, palpitations, or visual changes.
• Advise patient not to drink alcohol.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects vision, cognition, and balance.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.