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oxazepam

Adjunctive therapy

Last reviewed 2025-12-29

Reviewed by PsychMed Editorial Team.

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Quick answers

  • What is oxazepam?

    Oxazepam is a benzodiazepine indicated for the management of anxiety disorders (or short-term relief of anxiety symptoms) and for symptoms of acute alcohol withdrawal (label).

  • What is oxazepam used for?

    Label indications include: Management of anxiety disorders / short-term relief of anxiety symptoms; and alcohol withdrawal symptoms (label).

  • What drug class is oxazepam?

    Benzodiazepine; GABA-A receptor positive allosteric modulator.

  • What strengths does oxazepam come in?

    Capsules: 10 mg, 15 mg, 30 mg.

Snapshot

  • Class: Adjunctive therapy
  • Therapeutic drug monitoring not routinely recommended.
  • Last reviewed: 2025-12-29

Label indications

Management of anxiety disorders / short-term relief of anxiety symptoms; and alcohol withdrawal symptoms (label).

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Clinical Highlights

Oxazepam is a benzodiazepine indicated for the management of anxiety disorders (or short-term relief of anxiety symptoms) and for symptoms of acute alcohol withdrawal (label). Oxazepam is primarily cleared by glucuronidation (inactive metabolite), which reduces classic CYP interaction concerns; it is often considered when hepatic impairment or polypharmacy makes oxidative metabolism benzodiazepines harder to manage, especially in older or medically ill patients.

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  • Like all benzodiazepines, oxazepam carries meaningful dependence and withdrawal risk; targeted, time-limited plans are typical, and chronic maintenance for generalized anxiety is generally avoided when possible.
  • Alcohol withdrawal treatment typically follows a structured protocol; “benzodiazepine drift” into indefinite anxiety prescribing after withdrawal resolves is generally avoided.
  • The compare view to weigh alternatives, review the oxazepam evidence feed, and share the oxazepam print page for safe-use counseling.
  • Co-prescribing with opioids is generally avoided (boxed warning for opioid combinations), and driving and fall safety are commonly reassessed at renewals.
  • If anxiety is chronic, prioritize psychotherapy and SSRI/SNRI-based strategies over benzodiazepine maintenance (guidelines).

Dosing & Formulations

Capsules: 10 mg, 15 mg, 30 mg (label). Label dosing is divided (often 3–4 times daily) and varies by symptom severity and population; lowest-effective dosing for the shortest feasible duration is typical, with frequent reassessment (label).

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  • For alcohol withdrawal, a protocolized approach with frequent monitoring is typical; tapering usually follows symptom resolution.
  • In older adults, low starting doses with cautious titration are common to reduce confusion, falls, and oversedation (label).

Monitoring & Risks

Boxed warning: Concomitant use with opioids can cause profound sedation, respiratory depression, coma, and death (label). Sedation and psychomotor slowing: assess driving risk, fall risk, and occupational safety; alcohol and other sedatives are typically avoided.

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  • Dependence and withdrawal: tolerance and withdrawal symptoms are monitored; abrupt discontinuation after prolonged use is generally avoided.
  • Paradoxical disinhibition or worsening agitation can occur; discontinue discontinuation is often considered if symptoms worsen rather than improve.

Drug Interactions

Additive CNS and respiratory depression with alcohol, opioids, antihistamines, sedating antipsychotics, and other hypnotics—stacking sedatives is generally avoided. Oxazepam is not primarily CYP-metabolized, but interaction risk remains clinically driven by combined sedative load and comorbid respiratory disease.

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  • If multiple sedating meds are required, use a single prescriber and increase follow-up frequency to reduce overdose and misuse risk.

Practice Notes

Indication and time horizon are typically documented at initiation; continuation after the acute target resolves (e.g., post-withdrawal) is generally avoided. Psychotherapy and SSRI/SNRI plans are typically prioritized for chronic anxiety; benzodiazepines are often reserved for time-limited, goal-directed use.

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  • When discontinuing after longer use, tapering is typically gradual with monitoring for rebound anxiety and insomnia.
  • In very elderly patients, elimination can be prolonged; reassess dose and necessity frequently (label).

References

  1. Oxazepam prescribing information — DailyMed (2025)
  2. ASAM guideline on benzodiazepines — Journal of Addiction Medicine (2020)
  3. Evidence Based Pharmacological Treatment OF Anxiety Disorders — Depression and Anxiety (2014)
  4. Guidelines FOR THE Pharmacological Treatment OF Anxiety Disorders, Obsessive Compulsive Disorder AND Posttraumatic Stress Disorder IN Primary Care — International Journal of Psychiatry in Clinical Practice (2012)
  5. The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management — Journal of Addiction Medicine (2020)
Oxazepam — Summary — PsychMed