sedation. Use Caution/Monitor.shepherd's purseMonitor Closely (1)oxazepam and shepherd's purse both increase sedation. Use Caution/Monitor.sodium oxybateSerious - Use Alternative (1)oxazepam, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.stiripentolMonitor Closely (1)stiripentol, oxazepam. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.sufentanilMonitor Closely (1)oxazepam and sufentanil both increase sedation. Use Caution/Monitor.sufentanil SLSerious - Use Alternative (1)sufentanil SL, oxazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.suvorexantMonitor Closely (1)suvorexant and oxazepam both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessarytapentadolMonitor Closely (1)oxazepam and tapentadol both increase sedation. Use Caution/Monitor.teduglutideMonitor Closely (1)teduglutide increases levels of oxazepam by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.temazepamMonitor Closely (1)oxazepam and temazepam both increase sedation. Use Caution/Monitor.terbutalineMonitor Closely (1)oxazepam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thioridazineMonitor Closely (1)oxazepam and thioridazine both increase sedation. Use Caution/Monitor.thiothixeneMonitor Closely (1)oxazepam and thiothixene both increase sedation. Use Caution/Monitor.topiramateMonitor Closely (1)oxazepam and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)oxazepam and tramadol both increase sedation. Use Caution/Monitor.trazodoneMonitor Closely (1)oxazepam and trazodone both increase sedation. Use Caution/Monitor.triazolamMonitor Closely (1)oxazepam and triazolam both increase sedation. Use Caution/Monitor.triclofosMonitor Closely (1)oxazepam and triclofos both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (1)oxazepam and trifluoperazine both increase sedation. Use Caution/Monitor.trimipramineMonitor Closely (1)oxazepam and trimipramine both increase sedation. Use Caution/Monitor.triprolidineMonitor Closely (1)triprolidine and oxazepam both increase sedation. Use Caution/Monitor.valerianSerious - Use Alternative (1)valerian and oxazepam both increase sedation. Avoid or Use Alternate Drug.vinpocetineMinor (1)oxazepam increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).xylometazolineMonitor Closely (1)oxazepam increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbineMonitor Closely (1)oxazepam increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideMonitor Closely (1)oxazepam and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneMonitor Closely (1)oxazepam and ziprasidone both increase sedation. Use Caution/Monitor.zolpidemMinor (1)zolpidem, oxazepam. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.zotepineMonitor Closely (1)oxazepam and zotepine both increase sedation. Use Caution/Monitor. Frequency Not Defined Sedation Ataxia Confusion Memory impairment Dizziness Drowsiness Muscle weakness Syncope edema Leukopenia, blood dyscrasias Decreased libido Rash Incontinence Menstrual irregularities Jaundice Blured vision; diplopia 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 Continued use of benzodiazepines may lead to clinically significant physical dependence; longer treatment duration and higher daily dose increases risk of dependence and withdrawal symptoms; rapid dose reduction or abrupt discontinuation after continued use may result in withdrawal reactions that can be life-threatening; to reduce risk of withdrawal reactions gradual taper recommended when discontinuing drug or reducing dosage 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 Contraindications Documented hypersensitivity Cautions Use caution in respiratory diseases (COPD), sleep apnea, depression, suicide ideation, history of drug abuse Continued use of benzodiazepines may lead to clinically significant physical dependence; longer treatment duration and higher daily dose increases risk of dependence and withdrawal symptoms; rapid dose reduction or abrupt discontinuation after continued use may result in withdrawal reactions that can be life threatening; to reduce risk of withdrawal reactions gradual taper recommended when discontinuing drug or reducing dosage Use caution in patients with hepatic impairment, depression, respiratory disease, and debilitated and elderly patients at risk of falls and traumatic injuries Not for use as analgesic, antipsychotic, or antidepressant Patients should be warned that the effects of alcohol or other depressant drugs may be additive to those of oxazepam, which may require adjusting dosage or elimination of such patients Anterograde amnesia reported with benzodiazepines Sleep-related hazardous activities, including sleep-driving, making phone calls, cooking, and eating food reported with benzodiazepines Hypotension reported; use caution in patients with cardiovascular or cerebrovascular disease or patients who do not tolerate transient decreases in blood pressure Paradoxical reactions, including aggressive and hyperactive behavior reported with benzodiazepines, especially in pediatric/adolescent or psychiatric patients Physical and psychological dependence Withdrawal symptoms, similar in character to those noted with barbiturates and alcohol, including tremor, convulsions, vomiting, abdominal and muscle cramps, and sweating reported following abrupt discontinuation of oxazepam Withdrawal reported to be more severe in patients who received excessive doses over extended period; milder withdrawal symptoms, including dysphoria and insomnia reported following abrupt discontinuation of benzodiazepines taken continuously at therapeutic levels for several months Avoid abrupt discontinuation after extended therapy; dosage tapering should be scheduled under careful surveillance when receiving oxazepam or other psychotropic agents because of predisposition of such patients to habituation and dependence Pregnancy Category: D Lactation: Avoid during breastfeeding Minor tranquilizers should be avoided in 1st trimester of pregnancy due to increased risk of congenital malformations Maternal use shortly before delivery is associated with floppy infant syndrome (good and consistent evidence) Prenatal benzodiazepine exposure slightly increased oral cleft risk (limited or inconsistent evidence)Pregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Binds receptors at several sites within the CNS, including the limbic system and reticular formation. Effects may be mediated through GABA receptor system. Increase in neuronal membrane permeability to chloride ions enhances the inhibitory effects of GABA; the shift in chloride ions causes hyperpolarization (less excitability) and stabilization of the nuronal membrane Pharmacokinetics Half-life elimination: 2.8-5.7 hr Peak plasma time: 3 hr Peak plasma concentration: 450 ng/mL Metabolism: Glucuronic acid conjugation Metabolites: No active metabolites Protein binding: 86-99% Excretion: Urine BRAND FORM. UNIT PRICE PILL IMAGE oxazepam oral- 30 mg capsuleoxazepam oral- 15 mg capsuleoxazepam oral- 10 mg capsuleoxazepam oral- 10 mg capsuleCopyright © 2010 First DataBank, Inc.Print Patient Educationoxazepam oral OXAZEPAM - ORAL (ox-AZ-eh-pam) COMMON BRAND NAME(S): Serax WARNING: Oxazepam has a risk for abuse and addiction, which can lead to overdose and death. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems (especially opioid medications such as codeine, hydrocodone) may cause 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. Be sure you know how to take oxazepam and what other drugs you should avoid taking with it. See also Drug Interactions section. 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.Suddenly stopping this medication may cause serious (possibly fatal) withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as headaches, trouble sleeping, restlessness, hallucinations/confusion, depression, nausea, or seizures. Withdrawal symptoms may sometimes last weeks to months. USES: 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).This medication may also be used for sleep (insomnia) HOW TO USE: See also Warning section.Read the Medication Guide provided by your pharmacist before you start taking oxazepam and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth as directed by your doctor. The dosage is based on your medical condition, age, and response to therapy.When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.Tell your doctor if your condition lasts or gets worse. SIDE EFFECTS: See also Warning section.Drowsiness, dizziness, blurred vision, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: mental/mood changes, trouble speaking, clumsiness, trouble walking, decreased/increased interest in sex, tremor, trouble urinating, sleep disturbances, fainting, unusual tiredness, signs of liver disease (such as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine), signs of infection (such as sore throat that doesn't go away, fever).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before taking oxazepam, tell your doctor or pharmacist if you are allergic to it; or to other benzodiazepines (such as diazepam, temazepam); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, lung/breathing problems (such as 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).Older adults may be more sensitive to the side effects of this drug, especially drowsiness. This side effect can increase the risk of falling.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using oxazepam. Oxazepam may harm an unborn baby. Newborn