Serax (oxazepam) is an antianxiety medication usually prescribed for short periods of time to help ease symptoms of anxiety. It also helps to relieve sleeplessness caused by being anxious. Oxazepam is the metabolite of several other benzodiazepines.

Additionally, Serax is useful for treating conditions such as depression, insomnia, psychosis, suppression of transplant rejection, and can also be given in adjunctive therapy as an alternative drug of choice for alcohol dependence and alcohol withdrawal.

How Does Serax Work?

This drug affects the limbic, thalamic, and hypothalamic levels of the central nervous system, which results in anxiolytic, sedative, hypnotic, skeletal muscle relaxant, and anticonvulsant effects. The effects of this medication inhibit the neurotransmitter gamma-aminobutryic acid, or GABA.

Serax produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferent pathways together with inhibition of monosynaptic afferent pathways. This is achieved by inhibiting neuronal transmitters or by blocking excitatory synaptic transmission. This medication also depresses motor nerve and muscle function.

Dosage FAQs

  • What is a safe dose of this drug?
    • Mild to moderate anxiety: 10 mg to 15 mg is administered orally three to four times a day or as required.
    • Severe anxiety or anxiety associated with depression: 15 mg to 30 mg orally is administered three to four times a day or as required.
    • Alcohol withdrawal: 15 mg to 30 mg is administered orally three to four times a day or as required.
       
  • How does my body process this drug?
    This drug is well-absorbed in the gastrointestinal tract after oral administration. It reaches a maximum plasma concentration in about two to four hours. It has a slow onset of action, taking more than three hours to take effect. Serax undergoes hepatic metabolism (glucuronidation) and has no active metabolites. It has a half-life of about 8 hours (ranging between about six to 11 hours) after which it is eliminated via urine.
     
  • Is this drug safe to take during pregnancy?
    The U.S. Food and Drug Administration (FDA) has not officially assigned this medication to a pregnancy category, although that does not indicate it is safe to use during pregnancy. This drug, and other benzodiazepines, has been associated with an increased risk of birth defects when used during the first trimester. Serax, in particular, increases risk to the fetus during the third trimester of pregnancy. Alternative treatments should be considered for pregnant mothers before using this drug and a thorough assessment should be performed between you and your doctor to determine if the risks are worth the benefits this drug may bring.
     

  • Find a Therapist

    Advanced Search
    Are there ways to get more out of my treatment with this drug?
    This drug is primarily prescribed to treat anxiety, a condition that is regularly addressed with different types of psychotherapies. If you are prescribed this drug, consider finding a therapist or counselor with whom you can pair your treatment. Many studies indicate the best mental health outcomes often result from a combined approach to treatment using medication and psychotherapy.

Drug Interactions of Serax

This medication, like many other benzodiazepines, has several important drug interactions of which to be aware. If you are prescribed this medication, be sure to disclose all other medications, supplements, and vitamins you take before beginning treatment. The following drug interactions may occur:

  • Triprolidine: Triprolidine and Serax both depress the central nervous system. Monitor for increased depressant effects during concomitant therapy.
  • Vigabatrin: Vigabatrin increases the plasma concentration of Serax by 30% and decreases the time to reach maximum concentration by 45%.
  • Monoamine Oxidase Inhibitors (MAOIs): MAOIs can lower blood pressure and increase sedation. On concomitant administration with this category of drugs, the respiratory system is also depressed.
  • Sedatives or Sleeping Pills: These medications may cause severe sedation and may be fatal when taken with Serax.
  • Carbamazepine, Tricyclic Antidepressants, Phenytoin, and Theophylline: These drugs can decrease the effectiveness of Serax.

Additionally, the following drugs may affect the metabolism of Serax and/or increase the risk of toxicity if administered with Serax:

  • Cimetidine
  • Clozapine
  • Fluconazole
  • Ketoconazole
  • Indinavir
  • Nelfinavir
  • Itraconazole
  • Omeprazole
  • Ritonavir
  • Saquinavir
  • Voriconazole
  • Telithromycin
  • Oral contraceptives

Possible Side Effects

If you experience any of the following side effects while taking this medication, please consult with your doctor right away:

  • Hypotension (especially when administered with other drugs)
  • Slowing or rapid heart beat
  • Difficulty breathing, especially during sleep
  • Drowsiness
  • Lethargy
  • Vertigo
  • Headaches
  • Tremors
  • Slurred speech
  • Excitement, delirium, or hallucinations
  • Difficulty standing or walking
  • Nausea, vomiting, or diarrhea
  • Cholestatic jaundice
  • Altered sex drive

Precautions

Serax is contraindicated for individuals experiencing:

  • Glaucoma
  • Asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems
  • Kidney disease
  • Liver disease
  • History of depression or suicidal tendencies
  • History of alcohol addiction

Additionally, tablets of this drug contain tartrazine dye which may cause allergic reactions. Individuals using this drug should have their liver and kidneys tested regularly.

Safe Withdrawal from Serax

In general, the longer a person takes this drug and the higher the dose, the greater incidence and severity with which he or she will experience withdrawal symptoms. Most withdrawal symptoms associated with Serax can be compared to alcohol withdrawal. If you need to stop taking this medication, you should consult with your doctor and come up with a safe plan to taper down your dosage. Do not stop taking this medication abruptly.

References:

  1. Busto U, Kaplan HL, Sellers EM (February 1980). "Benzodiazepine-associated emergencies in Toronto". American Journal of Psychiatry 137 (2): 224–7. PMID 6101526.
  2. MacKinnon GL; Parker WA. (1982). "Benzodiazepine withdrawal syndrome: a literature review and evaluation". The American Journal of Drug and Alcohol Abuse. 9 (1): 19–33. doi:10.3109/00952998209002608. PMID 6133446.
  3. Skerritt JH; Johnston GA. (May 6, 1983). "Enhancement of GABA binding by benzodiazepines and related anxiolytics". European Journal of Pharmacology. 89 (3–4): 193–8. doi:10.1016/0014-2999(83)90494-6. PMID 6135616.

Page content reviewed by James Pendleton, ND.