Oxazepam

How it works

It enhances the inhibitory action of GABA at the GABA-A receptor, increasing chloride conductance to produce anxiolytic, sedative and hypnotic effects.

Prescribing in practice

• Benzodiazepines should be used at the lowest effective dose for the shortest possible period because of the risk of tolerance, dependence and a withdrawal syndrome.
• There is additive sedation and respiratory depression with alcohol, opioids and other CNS depressants.
• Because it does not require oxidative hepatic metabolism, oxazepam is sometimes preferred in hepatic impairment and in the elderly, but caution and reduced exposure are still warranted.

Monitoring

Review the ongoing need for treatment regularly and monitor for excessive sedation, falls and emerging dependence.

Counselling the patient

• This medicine can cause drowsiness; avoid driving or operating machinery if affected.
• Do not drink alcohol while taking oxazepam.
• Do not stop suddenly after regular use; your prescriber will arrange a gradual reduction.

Evidence & guidelines

NICE and MHRA guidance support short-term, lowest-effective use of benzodiazepines such as oxazepam for anxiety because of the risk of dependence.