Oxazepam

Short-acting·Neurology - Sedatives & Hypnotics

Short-term anxiety, insomnia, alcohol withdrawal in hepatic impairment

PBSBENZOSerepax, Murelax15 mg tabletS4+1

Max Dose

120 mg/day

Half-life

4-15 h

Hepatic Safe

L.O.T. DRUG

Onset

SLOW

Rapid Summary

Overview

Short-acting benzodiazepine. Does not require hepatic Phase 1 metabolism. It is the safest, most predictable oral benzo for the elderly and patients with liver cirrhosis.

Maximum Dose

Max 120 mg/day (Typically 15-30 mg per dose).

Clinical Focus

Has a very slow onset of action. It produces zero 'rush' or euphoria, making it excellent for preventing abuse but terrible for acute panic attacks.

Bottom Line

Oxazepam is a short-acting benzodiazepine preferred in elderly and hepatic impairment (no active metabolites), but has slower onset than other BZDs and still carries dependence risk.

Formulation & Access

Brand Names

Serepax, Murelax

Oral Routes

Tablets (15 mg, 30 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Short-term anxiety, insomnia, alcohol withdrawal in hepatic impairment.

Clinical Place

The workhorse anxiolytic for the geriatric ward. Displaces Diazepam entirely in patients > 65 years.

Quick reference

Class & Role

Short-acting — Short-acting benzodiazepine.

Route / Formulation

Tablets (15 mg, 30 mg). (Serepax, Murelax)

Usual Dose & Max

PO 15-30 mg TDS to QID. Max 120 mg/day (Typically 15-30 mg per dose).

Key Indication Doses

Anxiety: PO 15-30 mg TDS to QID. Insomnia: PO 15-30 mg NOCTE (Take 1 hour before bed due to slow onset). Alcohol Withdrawal (in Cirrhosis): PO 15-30 mg q2h PRN based on CIWA-Ar scale. Elderly / Frail: Start at 7.5 mg (Half a 15mg tablet).

Best Uses

Oxazepam is a short-acting benzodiazepine preferred in elderly and hepatic impairment (no active metabolites), but has slower onset than other BZDs and still carries dependence risk.

Avoid / Cautions

Severe respiratory failure, Myasthenia Gravis. Pregnancy Category C.

Key Risks

Neurological: Sedation, falls risk, ataxia, confusion. (Much lower risk of multi-day 'hangover' compared to diazepam due to lack of metabolites). Respiratory: Respiratory depression (if mixed with opioids).

Key Interactions

Opioids, Alcohol (Fatal respiratory arrest). Impervious to CYP450 drug interactions. Safe to mix with Clarithromycin or Amiodarone.

Monitoring

Assess falls risk in the elderly. No specific routine laboratory tests required.

Clinical Pearl

Addicts rarely seek Oxazepam. Because it is highly water-soluble, it trickles into the brain slowly over 2 hours. It provides zero dopamine 'rush' or 'hit'. It simply smooths out the anxiety smoothly and safely.

Access

Serepax, Murelax15 mg tablet

Brand: Serepax, Murelax
Formulation: Tablets (15 mg, 30 mg)

Oxazepam

Short-acting·Neurology - Sedatives & Hypnotics

Short-term anxiety, insomnia, alcohol withdrawal in hepatic impairment

PBSBENZOSerepax, Murelax15 mg tabletS4+1

Max Dose

120 mg/day

Half-life

4-15 h

Hepatic Safe

L.O.T. DRUG

Onset

SLOW

Rapid Summary

Overview

Short-acting benzodiazepine. Does not require hepatic Phase 1 metabolism. It is the safest, most predictable oral benzo for the elderly and patients with liver cirrhosis.

Maximum Dose

Max 120 mg/day (Typically 15-30 mg per dose).

Clinical Focus

Has a very slow onset of action. It produces zero 'rush' or euphoria, making it excellent for preventing abuse but terrible for acute panic attacks.

Bottom Line

Oxazepam is a short-acting benzodiazepine preferred in elderly and hepatic impairment (no active metabolites), but has slower onset than other BZDs and still carries dependence risk.

Formulation & Access

Brand Names

Serepax, Murelax

Oral Routes

Tablets (15 mg, 30 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Short-term anxiety, insomnia, alcohol withdrawal in hepatic impairment.

Clinical Place

The workhorse anxiolytic for the geriatric ward. Displaces Diazepam entirely in patients > 65 years.

Quick reference

Class & Role

Short-acting — Short-acting benzodiazepine.

Route / Formulation

Tablets (15 mg, 30 mg). (Serepax, Murelax)

Usual Dose & Max

PO 15-30 mg TDS to QID. Max 120 mg/day (Typically 15-30 mg per dose).

Key Indication Doses

Best Uses

Oxazepam is a short-acting benzodiazepine preferred in elderly and hepatic impairment (no active metabolites), but has slower onset than other BZDs and still carries dependence risk.

Avoid / Cautions

Severe respiratory failure, Myasthenia Gravis. Pregnancy Category C.

Key Risks

Key Interactions

Opioids, Alcohol (Fatal respiratory arrest). Impervious to CYP450 drug interactions. Safe to mix with Clarithromycin or Amiodarone.

Monitoring

Assess falls risk in the elderly. No specific routine laboratory tests required.

Clinical Pearl

Access

Serepax, Murelax15 mg tablet

Brand: Serepax, Murelax
Formulation: Tablets (15 mg, 30 mg)