Adult: 15-25 mg given 1 hour before bedtime, may be increased up to Max of 50 mg if necessary. Use the lowest effective dose for the shortest possible duration. Dosage and treatment recommendations may vary among individual products or between countries (refer to specific product guidelines).
Oral Short-term management of anxiety
Adult: Usual dose: 7.5-15 mg 3 or 4 times daily for mild to moderate anxiety; may be increased to 15-30 mg 3 or 4 times daily for severe anxiety. Doses must be individualised based on patient response. Use the lowest effective dose for the shortest possible duration. Dosage and treatment recommendations may vary among individual products or between countries (refer to specific product guidelines). Elderly: Initially, 10 mg tid, may be increased up to 10-20 mg 3 or 4 times daily based on patient response. Use the lowest effective dose for the shortest possible duration. Dosage recommendations may vary among individual products or between countries (refer to specific product guidelines).
Oral Alcohol withdrawal syndrome
Adult: For the management of symptoms associated with alcohol withdrawal (e.g. anxiety, tremor): 15-30 mg 3 or 4 times daily. Dosage and treatment recommendations may vary among individual products or between countries (refer to specific product guidelines).
Special Patient Group
Debilitated patients: Initially, 10 mg tid, may be increased up to 10-20 mg 3 or 4 times daily based on patient response. Use the lowest effective dose for the shortest possible duration. Dosage recommendations may vary among individual products or between countries (refer to specific product guidelines).
Patient with depression, significant personality disorders, history of alcohol or drug abuse; respiratory disease (e.g. COPD); CV disease, cerebrovascular disease, intolerance to transient decreases in blood pressure; acute narrow-angle glaucoma. Debilitated patients and those at risk of falls. Avoid abrupt withdrawal. Renal and hepatic impairment. Elderly. Pregnancy and lactation. Concomitant use with opioids.
Adverse Reactions
Significant: CNS depression, anterograde amnesia, paradoxical reactions (e.g. restlessness, agitation, hyperactive or aggressive behaviour), hazardous sleep-related activities (e.g. sleep-driving, cooking and eating food, or making phone calls while asleep); increased risk of falls (particularly in elderly), drug tolerance, physical and psychological dependence; rebound insomnia/anxiety (after treatment discontinuation). Rarely, hypotension. Blood and lymphatic system disorders: Leucopenia, blood dyscrasias. Ear and labyrinth disorders: Vertigo. Eye disorders: Blurred vision, diplopia. Gastrointestinal disorders: Nausea. General disorders and administration site conditions: Oedema, fatigue. Hepatobiliary disorders: Jaundice. Musculoskeletal and connective tissue disorders: Muscle weakness. Nervous system disorders: Headache, dizziness, drowsiness, dysarthria, ataxia. Psychiatric disorders: Confusion, irritability, psychoses, hallucination, nightmares. Renal and urinary disorders: Urinary incontinence. Reproductive system and breast disorders: Altered libido. Skin and subcutaneous tissue disorders: Urticaria, morbilliform or maculopapular rash. Potentially Fatal: Withdrawal reactions (particularly if abruptly discontinued); drug addiction, abuse, and misuse.
PO: Z (Congenital malformations in an infant have been reported. Not recommended by some manufacturers.)
Patient Counseling Information
This drug may cause dizziness and drowsiness, if affected, do not drive or operate machinery.
Monitoring Parameters
Assess each patient for the risk of abuse, misuse, or addiction before initiation and during the treatment. Monitor respiratory and CV status as clinically needed; LFTs and CBC periodically. Closely monitor patients concomitantly receiving opioids for signs of respiratory depression and sedation.
Overdosage
Symptoms: Drowsiness, confusion, ataxia, nystagmus, dysarthria, lethargy, and in severe cases, hypotension, respiratory depression, or coma.
Management: Symptomatic and supportive treatment. Administer activated charcoal within 1 hour of ingestion (provided that the patient is not too drowsy). Maintain a clear airway in patients likely to sleep. Monitor vital signs, including CV and respiratory functions. Consider giving flumazenil to hospitalised patients to reverse the acute sedative effects of benzodiazepines.
Drug Interactions
May enhance CNS depressant effects with barbiturates, antipsychotics, narcotic analgesics, antidepressants, hypnotics, anaesthetics, anticonvulsants, sedative antihistamines, tizanidine, lofexidine, and nabilone. May reduce the therapeutic effects of levodopa. Additive muscle-relaxing effects with muscle relaxants. Plasma levels may be decreased with estrogen-containing contraceptives. Increased metabolism with rifampicin. Increased sedative effect with baclofen and probenecid. May reduce the clearance of zidovudine. May increase activity with CYP450 inhibitors. Potentially Fatal: May lead to profound sedation, respiratory depression, and coma with opioids.
Food Interaction
May increase the sedative effects with alcohol.
Action
Description: Mechanism of Action: Oxazepam, a short-acting benzodiazepine, binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron within the CNS, including the limbic system and reticular formation. It enhances the inhibitory actions of GABA on neuronal excitability by increasing neuronal membrane permeability to chloride ions, resulting in hyperpolarisation and stabilisation. Pharmacokinetics: Absorption: Well absorbed from the gastrointestinal tract. Time to peak plasma concentration: Approx 2-3 hours. Distribution: Crosses the placenta and enters breast milk. Volume of distribution: 0.6-2 L/kg. Plasma protein binding: 96-98%. Metabolism: Metabolised in the liver via glucuronide conjugation to form benzophenone (major inactive metabolite). Excretion: Via urine (as inactive glucuronide conjugate). Elimination half-life: Approx 4-15 hours.
Chemical Structure
Oxazepam Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4616, Oxazepam. https://pubchem.ncbi.nlm.nih.gov/compound/Oxazepam. Accessed Sept. 29, 2025.
Storage
Oral: Tab/Cap: Store between 15-30°C. Protect from light.
N05BA04 - oxazepam ; Belongs to the class of benzodiazepine derivatives anxiolytics. Used in the management of anxiety, agitation or tension.
References
Brayfield A, Cadart C (eds). Oxazepam. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/09/2025.Joint Formulary Committee. Oxazepam. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/09/2025.Oxazepam Capsule (Leading Pharma, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/09/2025.Oxazepam Tablets BP 10 mg (Accord-UK Ltd). MHRA. https://products.mhra.gov.uk. Accessed 01/09/2025.Oxazepam. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/09/2025.Oxazepam. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/09/2025.
Sign Out
Continue with Google