oxazepam: clinical use

Prescribing considerations

• Confirm anxiety is sufficiently severe to match the licensed indication and document the intended treatment-ending strategy before initiation.
• Review concurrent prescribed, over-the-counter and online medicines, alcohol use, substance-use history and psychiatric history.
• Assess risks of sedation, cognitive impairment, falls, tolerance, dependence, misuse and withdrawal.
• Avoid abrupt cessation; individualise withdrawal and adjust if symptoms become intolerable.
• Use particular caution in older or debilitated people and in renal, hepatic or chronic respiratory impairment.
• Do not use oxazepam alone to treat depression or as primary treatment for psychotic illness.

Contraindications and cautions

• Hypersensitivity to oxazepam, another benzodiazepine or a product component
• Respiratory depression or acute pulmonary insufficiency
• Sleep apnoea syndrome
• Myasthenia gravis
• Severe hepatic insufficiency
• Chronic psychosis
• Phobic or obsessional states

Monitoring

• Sedation, respiratory function and consciousness when opioids or other depressants are present
• Therapeutic response, ongoing clinical need and evidence of tolerance, misuse, dependence or withdrawal
• Falls, gait, coordination and cognitive effects, especially in older people
• Mood, behavioural disinhibition and suicidal thinking
• Renal and hepatic status where impaired; consider blood count and liver-function assessment if repeated courses are clinically necessary

Clinical pharmacology

Oxazepam is an active benzodiazepine that enhances GABA-mediated inhibition. It is absorbed orally, highly protein bound, and converted by glucuronidation to a pharmacologically inactive metabolite without active oxidative metabolites.

Formulation and product differences

• The selected product is a white, round oral tablet with a break bar and contains lactose, maize starch and magnesium stearate.
• Do not assume the break bar supports equal dose division unless current product information or the manufacturer confirms this.

Tablet

Route: Oral

Strengths: 10 mg, 15 mg