Serax (oxazepam)

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 Serax

Take this medication by mouth as directed by your doctor. The dosage is based on your medical condition, age, and response to therapy.

Use this medication exactly as prescribed. Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for an extended period of time, do not suddenly stop using this drug without your doctor’s approval. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased to avoid side effects such as seizures.

When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

Inform your doctor if your condition persists or worsens.

Warning!
• This medicine causes drowsiness and muscle weakness and impairs concentration and alertness. These effects may continue into the following day and are made worse by drinking alcohol. If you are affected you should avoid potentially hazardous tasks such as driving or operating machinary. Avoid alcohol.
• This medicine is generally only suitable for short-term use. If it is used for long periods or in high doses, tolerance to and dependence upon the medicine may develop, and withdrawal symptoms such as headaches, muscle pain, rebound insomnia, anxiety, restlessness, confusion, sweating, irritability or convulsions may then occur if treatment is stopped suddenly. Your body may also become tolerant to the medicine, with higher doses needed to achieve the same effect. For this reason, you should not exceed the dose of this medicine prescribed by your doctor, or take it for longer than recommended. If you are still having trouble with anxiety or sleeping after this time you should consult your doctor for further advice.
• Treatment with this medicine should usually be stopped gradually, following the instructions given by your doctor, in order to avoid withdrawal symptoms and a return in your anxiety or sleeping problems.

Use with caution in
Elderly people.
• Weak or debilitated people.
• Decreased kidney function.
• Decreased liver function.
• Disease affecting the airways or lungs (respiratory disease).
• Abnormal muscle weakness (myasthenia gravis).
• Hereditary blood disorders called porphyrias.
• Glaucoma.
• History of alcoholism or drug abuse.
• Personality disorders.
• Depression.
• It is important to tell your doctor if you have recently suffered a loss or bereavement, for example the death of a close friend or relative, before taking this medicine. Benzodiazepines such as this one can affect the way you adjust psychologically to events like this.

Not to be used in
• Children.
• Allergy to benzodiazepines.
• A sudden worsening of any underlying lung disease (acute pulmonary insufficiency).
• Slow, shallow breathing (respiratory depression).
• Syndrome involving short spells when breathing stops during sleep (sleep apnoea syndrome).
• Long-term psychotic illness.
• Phobias or obsessional states.
• Severely decreased liver function.
• Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine may be harmful to a developing baby and it should be avoided during pregnancy unless considered essential by your doctor. This is particularly important during the first and third trimesters of pregnancy and before or during labour. Regular use during pregnancy should especially be avoided, as the baby could become dependent on the medicine and then suffer withdrawal symptoms after the birth. If this medicine is used in late pregnancy or during labour it may cause floppiness, low body temperature and breathing or feeding difficulties in the baby after birth. Ask your doctor for further information.
• Significant amounts of this medicine may pass into breast milk. It should not be used by breastfeeding mothers as it may be harmful to the nursing infant. Seek medical advice from your doctor.

Label warnings
• This medication causes drowsiness which may continue the next day. If affected do not drive or operate machinery. Avoid alcoholic drink.

Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

• Drowsiness.
• Drowsiness and lightheadedness the next day.
• Confusion.
• Shaky movements and unsteady walk (ataxia).
• Loss of memory (amnesia).
• Unexpected increase in aggression (paradoxical aggression).
• Muscle weakness.
• Dizziness.
• Headache.
• Skin rashes.
• Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.
• Difficulty in passing urine (urinary retention).
• Visual disturbances such as blurred vision.
• Changes in sex drive.
• Low blood pressure (hypotension).
• Blood disorders.
• Jaundice.

The side effects listed above may not include all of the side effects reported by the medicine’s manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

There may be an increased risk of drowsiness and sedation if oxazepam is taken with any of the following (which can also cause drowsiness):

• alcohol
• antipsychotics, eg chlorpromazine, clozapine
• barbiturates, eg phenobarbital
• other benzodiazepines, eg temazepam
• MAOI antidepressants, eg phenelzine
• sedating antihistamines, eg chlorphenamine
• sleeping tablets, eg zopiclone
• strong opioid painkillers, eg morphine, codeine, dihydrocodeine
• tricyclic antidepressants, eg amitriptyline.

The following medicines may decrease the blood level of oxazepam. As this could make it less effective, your doctor may need to prescribe you a larger than normal dose of oxazepam if you are taking any of these medicines:

• phenytoin
• rifampicin.

Probenecid may prevent the breakdown of oxazepam in the body. As this could increase the blood level of oxazepam and its sedative effects, as well as the risk of its side effects, your doctor may need to prescribe you a lower than normal dose of oxazepam if you are taking probenecid.

Caffeine and theophylline may reduce the sedative and anxiety-reducing effects of oxazepam.