- Capsules 10 mg
- Capsules 15 mg
- Capsules 30 mg
Potentiates action of GABA, an inhibitory neurotransmitter, resulting in increased neuronal inhibition and CNS depression, especially in limbic system and reticular formation.
Readily absorbed orally. T max is 2 to 4 h; C max is approximately 450 mg/mL.
Protein bound approximately 87%.
In liver to inactive compounds (glucuronide conjugates).
Excreted in the urine. The t ½ is 8.2 h.
Indications and Usage
Control of anxiety, anxiety associated with depression; control of anxiety, tension, agitation, and irritability in elderly; treatment of alcoholic patients with acute tremulousness, inebriation, or anxiety associated with alcohol withdrawal.
Hypersensitivity to benzodiazepines; psychoses.
Dosage and AdministrationMild to Moderate Anxiety with Associated Tension, Irritability, and Agitation
PO 10 to 15 mg 3 to 4 times daily.Severe Anxiety Syndromes, Agitation or Anxiety Associated with Depression, Alcoholics with Acute Inebriation and Tremulousness, or Anxiety on Withdrawal
PO 15 to 30 mg 3 to 4 times daily.Elderly
PO 10 mg 3 times daily; increase cautiously up to 15 3 to 4 times daily.
Store capsules at controlled room temperature (59° to 86°F).
Drug InteractionsAlcohol, CNS depressants
Additive CNS depressant effects.Digoxin
Increased serum digoxin concentrations.Theophyllines
May antagonize sedative effects of oxazepam.
Laboratory Test Interactions
None well documented.
Changes in ECG pattern; hypotension; syncope.
Drowsiness; dizziness; lethargy; vertigo; tremor; fatigue; memory impairment; disorientation; anterograde amnesia; ataxia; hallucinations; restlessness; headache; slurred speech; stupor; euphoria; paradoxical reactions (eg, anger, hostility, mania, insomnia).
Rashes (morbilliform, urticaria, maculopapular).
Blurred vision; diplopia.
Blood dyscrasias including agranulocytosis; leukopenia.
Hepatic function impairment and jaundice.
Dependence/withdrawal syndrome (eg, confusion, abnormal perception of movement, depersonalization, muscle twitching, psychosis, paranoid delusions, seizures); edema; altered libido; incontinence; fever; menstrual irregularities.
Category D .
Dosage and efficacy not established in children younger than 6 yr of age; absolute dosage not established for patients 6 to 12 yr of age.
For elderly and debilitated patients, initial dose should be small; increase gradually.
Prolonged use may lead to dependence. Withdrawal syndrome has occurred within 4 to 6 wk of treatment with therapeutic doses, especially if abruptly discontinued. Use caution and taper dosage.
Long-term use (more than 4 mo)
Effectiveness has not been assessed.
Not intended for use in patients with primary depressive disorder, psychoses, or disorders in which anxiety is not prominent.
Use drug with caution in patients with suicidal tendencies; do not allow access to large quantities of drug.
Drowsiness, mental confusion, lethargy, ataxia, hypotonia, hypotension, hypnotic state, coma, death.
- Advise patient or caregiver to read the patient information leaflet before starting therapy and with each refill.
- Advise patient that medication is usually started at a low dose and then gradually increased until max benefit is obtained.
- Caution patient that medication may be habit forming, to take as prescribed, and not to stop taking or change the dose unless advised by health care provider.
- Advise patient to take each dose without regard to meals but to take with food if stomach upset occurs.
- Advise patient that if a dose is missed to skip that dose and take the next dose at the regularly scheduled time. Caution patient to never take 2 doses at the same time.
- Advise patient that if medication needs to be discontinued it will be slowly withdrawn unless safety concerns (eg, rash) require a more rapid withdrawal.
- Instruct patient to avoid alcoholic beverages and other depressants while taking this medication.
- Advise patient with anxiety to take as needed and to seek alternative methods for controlling or preventing anxiety (eg, stress reduction, counseling).
- Instruct patient to contact health care provider if symptoms do not appear to be getting better, are getting worse, or if bothersome adverse reactions (eg, drowsiness, memory impairment) occur.
- Advise patient that drug may cause drowsiness or impair judgment, thinking, or reflexes and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
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