Cloxazolam is a benzodiazepine medication unavailable in the US, but marketed in some European countries, Asia and Brazil. Benzodiazepines are a class of medication that acts selectively on the brain's gamma-aminobutyric acid (GABA) neurotransmitter system to produce mild sedation as well as muscle relaxant, anticonvulsant and anti-anxiety effects. Cloxazolam is usually administered for preoperative nervousness and as a short-term treatment — generally less than 14 days — for anxiety. This medication is administered orally, throughout the day, with a usual adult dosage of up to 12 mg per day for treatment of anxiety. A preoperative dosage may be as much as 100 mg per kilogram of body weight in a one-time dose.
Cloxazolam is a long-acting benzodiazepine with a half-life of 65 hours. This essentially means that a one-half of a given dose remains biochemically active as long as 65 hours after administration. For comparison, a common short-term benzodiazepine, oxazepam, has a half-life of eight hours while a longer-acting member of this drug family can demonstrate a half-life of up to 100 hours. As with most benzodiazepines, cloxazolam is metabolized in the liver and excreted by the kidneys. For this reason, elderly patients and patients with pre-existing liver disease may require decreased doses or fewer doses administered per day.
Side effects of cloxazolam also common to other benzodiazepines include sedation, confusion, memory loss and difficulty with balance. Specifically, cloxazolam is also known to cause palpitations, a rapid heart rate and high blood pressure at times. Changes in muscle tone, involuntary motor movement such as tics, diaphoresis or sweating and a susceptibility to infections may also occur as specific side effects of this medication. Cloxazolam also interacts with other sedative medications, sleep medications, pain medications and alcohol to cause potentially life-threatening sedation and respiratory depression. Combining this medication with any of the medication types noted above should be avoided without explicit physician approval.
Long-term use of any benzodiazepine medication, including cloxazolam, can lead to physical and psychological dependency upon the medication as the body's physiology comes to rely upon the medication's effects. Benzodiazepines should never be stopped abruptly or without medical supervision. The majority of programs for benzodiazepine dependency rely on a very slow taper program — often months in duration — in order to avoid life-threatening withdrawal side effects. During a benzodiazepine taper, patients are also taught life skills such as relaxation techniques, exercise or meditation to deal with stressful situations they will undoubtedly encounter.
