Oxazepam

Indications

Oxazepam is used for: Anxiety, Insomnia, Alcohol withdrawal syndrome

Adult Dose

Oral Anxiety Mild/moderate: 10-15 mg 3-4 times/day. Severe, agitation or assoc with depression: 15-30 mg 3-4 times/day. Insomnia associated with anxiety Adult: 15-25 mg given 1 hr before bedtime. Alcohol withdrawal syndrome; Anxiety Adult: 15-30 mg 3 or 4 times daily. Elderly: Initially, 10 mg tid, increase up to 10-20 mg 3 or 4 times daily as necessary.

Child Dose

Oral Anxiety Child >12 years Mild/moderate: 10-15 mg 3-4 times/day. Severe, agitation or assoc with depression: 15-30 mg 3-4 times/day.

Renal Dose

Renal impairment: No dosage adjustment needed.

Administration

May be taken with or without food.

Contra Indications

Not for the treatment of psychoses. Pregnancy and lactation. Hypersensitivity, Acute alcohol intoxication, Myasthenia gravis (allowable in limited circumstances) Severe respiratory depression, Depressed neuroses.

Precautions

Patient w/ CV or cerebrovascular disease, acute narrow-angle glaucoma, suicidal tendencies, history of drug abuse or acute alcoholism, myasthenia gravis, chronic pulmonary insufficiency or sleep apnoea. Not intended for treatment of psychoses. Avoid abrupt withdrawal. Hepatic and renal impairment. Elderly or debilitated patient. Pregnancy and lactation. Patient Counselling May impair ability to perform hazardous activities requiring mental alertness or physical coordination (e.g. operating machinery, driving). Monitoring Parameters Monitor resp and CV status. Periodic monitoring of CBC and LFTs. Lactation: Avoid during breastfeeding

Pregnancy-Lactation

Interactions

Additive CNS depressant effects w/ barbiturates, antipsychotics, sedatives/hypnotics, anxiolytics, antidepressants, sedative antihistamines, anticonvulsants, and anaesth. Increased psychic dependence w/ narcotic analgesics. CYP450 inhibitors may enhance benzodiazepine activity.

Adverse Effects

Side effects of Oxazepam : Sleep and visual disturbances, drowsiness, dizziness, vertigo, lethargy, headache, tremor, ataxia, mild paradoxical reactions (e.g. excitement, stimulation of affect), minor diffuse skin rashes (e.g. morbilliform, maculopapular and urticarial), nausea, oedema, slurred speech, altered libido, GI symptoms. Rarely, transient anterograde amnesia or memory impairment, syncope, leucopenia and hepatic dysfunction including jaundice.

Mechanism of Action

Oxazepam is a short-acting benzodiazepine. It increases neuronal membrane permeability to Cl ions by binding to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron w/in the CNS (including the limbic system, reticular formation) and enhancing the GABA inhibitory effects resulting in hyperpolarisation and stabilisation.