oxazepam (Serax)
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Introduction
Tradename: Serax. DEA-controlled substance: class 4.
Indications
- treatment of anxiety
- short-term management of panic attacks
- muscle spasms
- alcohol withdrawal
- anticonvulsant in management of simple partial seizures
Contraindications
- pre-existing CNS depression
- narrow-angle glaucoma
Dosage
(1 mg lorazepam = 15 mg oxazepam)
- 10-15 mg PO TID/QID[1]
- 30-120 mg/24 hours PO TID/QID[2]
- 15-30 mg PO every 6-8 hours (alcohol withdrawal)
Tabs: 10, 15, 30 mg.
Pharmacokinetics
- well absorbed orally
- onset of action is 10-30 minutes
- peak effect in 2-4 hours
- 1/2life is 5-20 hours
- duration of action is 6-8 hours
- metabolized by conjugation in the liver[6]
- metabolites are pharmacologically inactive[2]
- metabolites eliminated in the urine
elimination via kidney
1/2life = 5-15 hours
protein binding = 96-98 %
elimination by hemodialysis = -
Adverse effects
- common (> 10%)
- drowsiness, fatigue, impaired coordination, lightheadedness, memory impairment, insomnia, dysarthria, anxiety, decreased libido, depression, headache, dry mouth, constipation, diarrhea, decreased salivation, nausea, vomiting, tachycardia, chest pain, blurred vision, sweating, rash, increased or decreased appetite
- less common (1-10%)
- uncommon (< 1%)
- menstrual irregularities, blood dyscrasia, reflex slowing urinary incontinence
- other[3]
- drug adverse effects of benzodiazepines
- drug adverse effects of psychotropic agents
- drug adverse effects of sedatives
Drug interactions
- agents that decrease metabolism &/or increase absorption of oxazepam
- CNS depressants in combination increase CNS depression
- antiepileptic agents & rifampin increase metabolism of benzodiazepines
- flumazenil (Romazicon) antagonizes effects of benzodiazepines
- drug interaction(s) of methadone in combination with benzodiazepines
- drug interaction(s) of benzodiazepines with antidepressants
- drug interaction(s) of benzodiazepines with thiazide diuretics
- drug interaction(s) of antipsycotics with benzodiazepines
- drug interaction(s) of antidepressants with benzodiazepines
- drug interaction(s) of beta-adrenergic receptor antagonists with benzodiazepines
- drug interaction(s) of beta-adrenergic receptor antagonists (except atenolol) with benzodiazepines
- drug interaction(s) of alcoholic beverage with benzodiazepines
- drug interaction(s) of benzodiazepine with opiates
Laboratory
- specimen: serum, plasma (EDTA) urine
- methods:
- interferences: carbamazepine may interfere with GLC
- labs with Loincs
Mechanism of action
- potentiates GABA's inhibitory effects by increasing neuronal membrane permeability to chloride
More general terms
References
- ↑ 1.0 1.1 The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996.
- ↑ 2.0 2.1 2.2 Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 7
- ↑ 3.0 3.1 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
- ↑ 6.0 6.1 UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001