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Created Oct 2020 | Updated Nov 2020


  • [SERAX]

DEA CODE 2835: Schedule 4

Many people can feel anxious from time to time. Anxiety is normal in stressful situations, and can even be helpful. However, anxiety can become abnormal if it appears for no apparent reason, or if it is out of proportion to a stressful situation, or if it continues after a stressful situation has passed. Oxazepam is an anti-anxiety medicine which is prescribed for short periods of time to help ease the symptoms of anxiety. Oxazepam works by affecting the way certain substances in your brain (called neurotransmitters) pass messages to your brain cells. It has a calming effect on your brain. The calming effect is helpful in people who have symptoms caused by anxiety, such as difficulties sleeping. Oxazepam has a calming effect. You will be prescribed it for anxiety for a short period of time only - from a few days to a maximum of four weeks. Oxazepam is likely to affect your reactions and ability to drive. These effects could last into the following day. It is an offense to drive while your reactions are impaired. Do not drink alcohol while you are on oxazepam.

Oxazepam comes in capsule form and is taken three to four times a day. What distinguishes oxazepam from other benzos is that it is one of the more slower-acting drugs of its class, with a half-life of between five and 20 hours. It is also less toxic than benzodiazepines like Librium or Valium. It also has a lower potential for abuse compared to other benzos. However, when taken in large enough doses or for a more extended period than necessary, oxazepam can produce distressing withdrawal symptoms and effects.

Oxazepam is an FDA-approved benzodiazepine used for the treatment of alcohol withdrawal as well as the management of anxiety disorders. Oxazepam has a variety of uses, including several outside of its approved indications such as confusional arousals, sleep terrors, social phobia, PTSD, insomnia, PMDD, and catatonia. Currently, oxazepam is not FDA-approved for use in children under the age of six due to the risk of respiratory arrest. Oxazepam can also be a recommended agent in patients who have difficulties remaining asleep in contrast to drugs helping to initiate sleep. Oxazepam classifies, as a short-intermediate acting benzodiazepine; its efficacy in long term use has undergone evaluation in clinical studies.

What is oxazepam, and how does it work:
It helps relieve anxiety by enhancing the activity of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is thought that excessive activity of nerves in the brain may be the cause of anxiety and other psychological disorders. Benzodiazepines such as oxazepam help to relieve anxiety by increasing the effects of GABA in the brain and spinal cord. Oxazepam was approved by the FDA in June, 1965.

Oxazepam is an older medication, having first been marketed in 1965. Since it's been around so long, it's available almost exclusively as a generic drug-brand name versions like Serax are difficult or impossible to find. However, the generic versions of the medication should work as well as prescription versions. Oxazepam works slowly compared to other benzodiazepine drugs.

Oxazepam is a benzodiazepine. As with all medications in that class of drugs, you can become addicted if you use the drug too frequently or for too long.

The most common side effect seen with the use of oxazepam is drowsiness or lethargy, especially when you first start to take the medication.

This medication should be stopped as soon as possible in pregnancy, but due to the possibility of withdrawal, this should only be done under the guidance of your physician.

Oxazepam can be a useful medication for the acute treatment of anxiety or alcohol withdrawal, and since it may have fewer side effects than some of the other benzodiazepines, may be a good choice in certain circumstances. At the same time, it's important to understand that benzodiazepines are strong medications with a potential for abuse and serious side effects, both due to the side effects of the drug alone or in combination with other drugs, and due to withdrawal side effects when it is discontinued.

Oxazepam is the first of a chemical series of compounds, the 3-hydroxybenzodiazepinones. A therapeutic agent providing versatility and flexibility in control of common emotional disturbances, this product exerts prompt action in a wide variety of disorders associated with anxiety, tension, agitation and irritability, and anxiety associated with depression. Oxazepam has distinguished itself clinically from other benzodiazepines by virtue of its excellent tolerance. Because of its excellent tolerance, dosage is very flexible, and it is, therefore, possible to utilize oxazepam in a wide spectrum of anxiety-related disorders including the psychoses. Oxazepam has been administered to humans by the oral route only. Usual ranges for kinetic parameters are: elimination half-life, 5 to 15 hours; volume of distribution, 0.6 to 2.0 L/kg; clearance, 0.9 to 2.0 ml/min/kg. Age and liver disease have a minimal influence on oxazepam kinetics, but renal disease is associated with a prolonged half-life and increased volume of distribution.

Oxazepam is an oral benzodiazepine used for the management of symptoms associated with anxiety disorders and for short-term amelioration of the symptoms of anxiety or anxiety associated with depression. Oxazepam is often preferable to chlordiazepoxide, flurazepam, and prazepam in treating anxiety or insomnia, particularly in the elderly or in patients with liver disease, because oxazepam has a relatively short half-life and does not generate active metabolites. Oxazepam was approved by the FDA in 1965.

As with other benzodiazepines, tolerance (or tachyphylaxis) may develop to the sedative effects of oxazepam. Anxiolytic effect tolerance has also been reported with benzodiazepine use. If tolerance develops, clinicians should carefully assess the need for escalating doses. A temporary reduction in dosage may be beneficial in some cases to reverse the effects of tachyphylaxis. Daytime anxiety or wakefulness during the last third of the night may develop after several weeks of consistent nightly dosing with oxazepam. These effects are thought to be due to the development of tolerance, which leads to a deficiency of benzodiazepine binding sites.

As with other benzodiazepines, prolonged use of oxazepam can produce physiological dependence with or without psychological dependence. The risk of dependence increases with duration of treatment and in those with a history of alcohol or drug abuse. Dependence can occur following routine use of therapeutic doses for as few as 1-2 weeks, particularly during treatment with short-acting benzodiazepines. Extreme caution is advised when considering the use of oxazepam in patients with a known or suspected history of substance abuse.

Prescribed for:
    What Conditions does it treat?
  • Anxious
  • Symptoms from alcohol withdrawal

Oxazepam is used to treat anxiety and also acute alcohol withdrawal. This medication belongs to a class of drugs called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming and an anti-seizure effect. It works by enhancing the effects of a certain natural substance in the body (GABA).

Before using:
Tell your doctor or pharmacist your medical history, especially of:

  • Liver disease
  • Kidney disease
  • Lung/breathing problems (e.g., COPD, sleep apnea)
  • Drug or alcohol abuse


  • This drug may make you dizzy or drowsy or blur your vision
  • Alcohol or marijuana (cannabis) can make you more dizzy or drowsy
  • Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely.
  • Avoid alcoholic beverages.
  • Talk to your doctor if you are using marijuana (cannabis).


Taking oxazepam with opioid medications (such as codeine, hydrocodone) may increase your risk of very serious side effects, including death.

To lower your risk, your doctor should have you take the smallest dose of oxazepam that works, and take it for the shortest possible time.

Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.

User Reviews:

49 Total User Reviews
Oxazepam Oral:
Read Reviews
Condition: Anxious (38 Reviews):

Ease of Use(4.29)


Side Effects:
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
  • a light-headed feeling, like you might pass out
  • tremors, weakness, slurred speech
  • sudden restless feeling or excitement
  • confusion, anger, aggression
  • hallucinations, feelings of extreme happiness
  • problems with balance or walking
  • memory problems
  • jaundice (yellowing of the skin or eyes)
  • sudden weakness or ill feeling, fever, chills, sore throat
Common side effects may include:
  • dizziness, spinning sensation
  • feeling restless or excited
  • drowsiness
  • headache
  • blurred vision
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

As with most benzodiazepines, oxazepam therapy has not been associated with serum aminotransferase or alkaline phosphatase elevations, and clinically apparent liver injury from oxazepam has not been reported and must be very rare, if it occurs at all.

Oxazepam Hepatotoxicity:
Oxazepam, like other benzodiazepines, is rarely associated with serum ALT elevations, and clinically apparent liver injury from oxazepam is extremely rare, if it occurs at all. There have been no case reports of symptomatic, acute liver injury from oxazepam. Cases of clinically apparent liver injury have been reported with other benzodiazepines including alprazolam, chlordiazepoxide, clonazepam, diazepam, flurazepam and triazolam. The clinical pattern of acute liver injury from benzodiazepines is typically cholestatic and mild-to-moderate in severity with a latency of 1 to 6 months. Fever and rash are uncommon as is autoantibody formation.

E Likelihood score: E (unlikely cause of clinically apparent liver injury).

Quazepam Chemical Safety Information
Chemical Safety Summary:
Main risks and target organs:
Central nervous system, causing depression of respiration and consciousness.
Summary of clinical effects:
Central nervous system (CNS) depression and coma, or paradoxical excitation, but deaths are rare when benzodiazepines are taken alone. Deep coma and other manifestations of severe CNS depression are rare. Sedation, somnolence, diplopia, dysarthria, ataxia and intellectual impairment are the most common adverse effects of benzodiazepines. Overdose in adults frequently involves co-ingestion of other CNS depressants, which act synergistically to increase toxicity. Elderly and very young children are more susceptible to the CNS depressant action. Intravenous administration of even therapeutic doses of benzodiazepines may produce apnoea and hypotension. Dependence may develop with regular use of benzodiazepines, even in therapeutic doses for short periods. If benzodiazepines are discontinued abruptly after regular use, withdrawal symptoms may develop. The amnesia produced by benzodiazepines can have medico-legal consequences.

Oxazepam (Rx)
Black Box Warnings:
Concomitant use of benzodiazepines and opioids may result in profound respiratory depression, coma, and death; administer concomitantly when there are no alternative options; limit dosages and durations to minimum required; monitor for signs and symptoms of respiratory depression and sedation
Addiction, abuse, and misuse
  • On September 2020, FDA addressed serious risks of benzodiazepine addiction, abuse, and misuse, which can lead to overdose and death
  • Physical dependence can occur when taken steadily for several days to weeks, even as prescribed
  • Stopping abruptly or reducing dosage too quickly can result in withdrawal reactions, including seizures, which can be life-threatening
  • Assess each patient's risk prior to prescribing and monitor regularly for the development of these behaviors or conditions


A prescription benzodiazepine with intermediate duration and half life. A sedative and hypnotic which may cause lowered inhibitions and amnesia in higher doses.

RouteOnsetDurationAfter Effects
Tripsit Factsheets
All ROAs:60-120 minutes4-6 hours1-10 hours
Oxazepam Duration
All other CNS depressants.
Typical benzodiazepine effects. Amnesic, anxiolytic, anticonvulsant, hypnotic, sedative.

Maximum Dosage:
Prescribers Digital Reference
Adults:120 mg/day PO
Geriatric:60 mg/day PO
>doses up to 120 mg/day may be needed to treat alcohol withdrawal.
Adolescents:120 mg/day PO
for anxiety.
6 to 12 years:
1 mg/kg/day PO
1 to 5 years:
Not recommended

Oxazepam may increase the risk of serious or life-threatening breathing problems, sedation, or coma if used along with certain medications. Tell your doctor if you are taking or plan to take certain opiate medications for cough such as codeine (in Triacin-C, in Tuzistra XR) or hydrocodone (in Anexsia, in Norco, in Zyfrel) or for pain such as codeine (in Fiorinal), fentanyl (Actiq, Duragesic, Subsys, others), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Astramorph, Duramorph PF, Kadian), oxycodone (in Oxycet, in Percocet, in Roxicet, others), and tramadol (Conzip, Ultram, in Ultracet). Your doctor may need to change the dosages of your medications and will monitor you carefully. If you take oxazepam with any of these medications and you develop any of the following symptoms, call your doctor immediately or seek emergency medical care immediately: unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness. Be sure that your caregiver or family members know which symptoms may be serious so they can call the doctor or emergency medical care if you are unable to seek treatment on your own. Drinking alcohol or using street drugs during your treatment with oxazepam also increases the risk that you will experience these serious, life-threatening side effects. Do not drink alcohol or use street drugs during your treatment.

Symptoms of oxazepam overdose include:

  • Blurred or double vision, rapid side-to-side movement of eyes
  • Confusion, slurred speech
  • Dizziness
  • Drowsiness, tiredness, fainting
  • Nausea
  • Rash
  • Slowed or absent breathing
  • Decreased alertness, or even coma (lack of responsiveness)
  • Weakness, uncoordinated movement, staggering gait (ataxia, seen commonly in children)

Important Information:

Never use oxazepam in larger amounts, or for longer than prescribed.

Avoid drinking alcohol. Dangerous side effects could occur.

Oxazepam may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

The sedative effects of oxazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking oxazepam.


Drug Interactions (364) Alcohol/Food Interactions (2) Disease Interactions (11)

What other drugs will affect Oxazepam?
Taking oxazepam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures. Other drugs may interact with oxazepam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

A total of 364 drugs are known to interact with Oxazepam.

  • 26 major drug interactions
  • 305 moderate drug interactions
  • 33 minor drug interactions


Summary of Use During Lactation:
Oxazepam has low levels in breastmilk, a short half-life relative to many other benzodiazepines, and is administration directly to infants.

Oxazepam would not be expected to cause any adverse effects in breastfed infants with usual maternal dosages.

No special precautions are required.

Drug Levels:
Oxazepam is a short-acting metabolite of diazepam.

Alternate Drugs to Consider:

Appropriate studies have not been performed on the relationship of age to the effects of oxazepam in children younger than 6 years of age.

Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of oxazepam in the elderly. However, elderly patients are more likely to have unwanted effects (eg, severe drowsiness, dizziness, lightheadedness, fainting, unusual behavior) and age-related kidney or liver problems, which may require caution and an adjustment in the dose for patients receiving oxazepam.

Other Interactions:

  • Cabbage

Other Medical Problems:
Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, or history of
  • Depression, or history of
  • Drug abuse or dependence, or history of
  • Hypotension (low blood pressure)
  • Lung or breathing problems
  • Mental health problems, or history of - Use with caution. May make these conditions worse
  • Kidney disease
  • Liver disease - Use with caution. The effects may be increased because of slower removal of the medicine from the body
  • Mental illness (eg, bipolar disorder, schizophrenia) - Should not be used in patients with this condition

EMC PDF Oxazepam

EMC Leaflet PDF Oxazepam

NEI PDF Oxazepam

FDA PDF Oxazepam

Caymanchem PDF Oxazepam

It is an intermediate-acting benzodiazepine with a slow onset of action, so it is usually prescribed to individuals who have trouble staying asleep, rather than falling asleep. It is commonly prescribed for anxiety disorders with associated tension, irritability, and agitation. It is also prescribed for drug and alcohol withdrawal, and for anxiety associated with depression. Physicians may use oxazepam outside its approved indications to treat social phobia, post-traumatic stress disorder, insomnia, premenstrual syndrome, and other conditions. Oxazepam is generally less toxic in overdose than other benzodiazepines. Benzodiazepine overdoses can be much more dangerous if a coingestion of other CNS depressants such as opiates or alcohol has occurred. 2 mg of oxazepam equates to 1 mg of diazepam

Oxazepam when taken during the third trimester, causes a definite risk to the neonate including a severe benzodiazepine withdrawal syndrome.

Brand names:
It is marketed under many brand names worldwide, including: Alepam, Alepan, Anoxa, Anxiolit, Comedormir, durazepam, Murelax, Nozepam, Oksazepam, Opamox, Ox-Pam, Oxa-CT, Oxabenz, Oxamin, Oxapam, Oxapax, Oxascand, Oxaze, Oxazepam, Oxazin, Oxepam, Praxiten, Purata, Selars, Serax, Serenal, Serepax, Seresta, Seresta, Serpax, Sobril, Tazepam, Vaben, and Youfei.

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