Meds and you

Updated 11 February 2013

Nitrazolam

Nitrazolam is a sedative hypnotic benzodiazepine medication and is indicated for the treatment of short term insomnia. It relieves tension and nervousness and relaxes the body.

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Nitrazolam is the active ingredient of Arem, Mogadon and Paxodorm.

General Information

Nitrazolam is a sedative hypnotic benzodiazepine medication and is indicated for the treatment of short term insomnia. It relieves tension and nervousness and relaxes the body. It should be administered immediately before bedtime.

Note that Nitrazolam remains active in the body for many hours and drowsiness may occur the next day.

This benzodiazepine should in most case not be used for longer than 2 - 4 weeks as tolerance and physical and psychological dependence can occur. Nitrazolam shares with other benzodiazepines the risk of abuse, misuse and psychological and/or physical dependence.

If prescribed for longer than 4 weeks your doctor should periodically reassess the need for nitrazolam

How does nitrazolam work?

Nitrazolam has an effect on gamma-aminobutyric acid (GABA). GABA is the brain's quieting or tranquilising neurotransmitter possessing an inhibitive effect on the transmission of nerve signals. Nitrazolam, and other benzodiazepines, enhance the effect of GABA, thus slowing down the transmission of nerve signals.

Fast facts

Drug schedule: Schedule 5

Available as: Nitrazolam is available as tablets and capsules.

What does it do? Nitrazolam has an anti-anxiety and anti-insomnia effect.

Overdose risk: Medium

Dependence risk: High

Is nitrazolam available as a generic? Yes

Is nitrazolam available on prescription only? Yes

User information

Onset of effect: Within 30 minutes

Duration of action: Up to 24 hours

Dietary advice: Nitrazolam may be taken with or without food.

Stopping this medicine: Nitrazolam should not be stopped abruptly. Sudden discontinuation may lead to withdrawal symptoms. The dosage of nitrazolam should be gradually reduced according to the advice of your doctor.

Prolonged use: Short-term therapy is advised. Treatment should generally be no longer than 4 - 6 weeks, including a tapering off process. Tolerance has been noted with long term use. Do not take nitrazolam for longer periods, unless strictly instructed by your doctor.

Special precautions

Never exceed the prescribed dose of nitrazolam.

Consult your doctor before using this drug if:

  • You have a known hypersensitivity to benzodiazepines
  • You have myasthenia gravis.
  • You have liver or kidney disease.
  • You have a history of alcohol or substance abuse
  • You have a chronic lung disease
  • You have a mental illness or depression
  • You have sleep apnoea
  • You have porphyria.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: Use with caution as side effects may be emphasised. Dosage may need adjustment.

Driving and hazardous work: This medication should be avoided, as it may cause extreme sedation.

Alcohol: Nitrazolam's effect may intensify the effect of alcohol and vice versa. Do not consume alcohol while taking this medication, as side effects may be drastically pronounced.

Possible side effects:

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Drowsiness/confusion

x

x

Loss of coordination/dizziness

x

x

Slurred speech

x

x

Unsteady walk

x

x

Visual disturbance

x

x

Extreme fatigue

x

x

Loss of memory

x

x

Rash/itching

x

x

Anger/behaviour changes

x

x

Headache

x

x

Bruising/bleeding

x

x

Interactions:

Drug interactions:

Alcohol, antihistamines, antidepressants, other benzodiazepines, narcotics

Increased depression of central nervous system (CNS)

Digoxin

Increased possibility of digoxin toxicity

Disulfiram

Increased possibility of nitrazolam toxicity

Ketokonazole and other related antifungals

Increased possibility of nitrazolam toxicity

Cimetidine

Increased possibility of nitrazolam toxicity

Isoniazid

Increased possibility of nitrazolam toxicity

Oral contraceptive

Increased possibility of nitrazolam toxicity

Propranolol

Increased possibility of nitrazolam toxicity

Valproic acid

Increased possibility of nitrazolam toxicity

Isoniazid

Increased possibility of a nitrazolam toxicity

Levodopa

Decreases levodopa's anti-Parkinson effect

Probenecid

Increased possibility of nitrazolam toxicity

Rifampicin

May decrease the effect of nitrazolam.

Theophylline

May counteract the sedative effects of nitrazolam.

Disease interactions

Consult your doctor before using this drug if you have acute closed-angle glaucoma, myasthenia gravis, liver or kidney disease, a chronic lung disease, you suffer from mental illness, depression or sleep apnoea.

Overdose action

An overdose of Nitrazolam can be serious. Seek immediate emergency medical attention. Symptoms may include poor coordination, slow breathing, tremors, drowsiness, slurred speech, confusion, slow reflexes and loss of consciousness.

Recommended dosage

1-2 mg/day at bedtime. Use strictly as prescribed by your doctor.

 

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