NITRAZEPAM

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Created Aug 2020 | Updated Nov 2020

NITRAZEPAM

  • [MOGADON]
  • [ALODORM]

DEA CODE 2834: Schedule 4

Nitrazepam is a long-acting, hypnotic benzodiazepine with anticonvulsant, sedative, and skeletal muscle relaxant effects. It is used to treat short-term insomnia, and cases of epilepsy. The drug is known to also have potent addictive properties and can cause dependence when taken over a long period. This is why it is only recommended for short-term use (7-10 days). Abuse of nitrazepam can easily lead to addiction, which has several known dangerous effects. People who misuse the drug for a while will eventually begin to take the drug habitually, as a result of the drug's effects. You may have begun to take this drug if you have severe issues with insomnia or other conditions, and you may want to continue taking the drug for its therapeutic benefits. Other illicit users mostly take nitrazepam for its calming and euphoric effects, or to boost the feelings of other drugs, such as alcohol and barbiturates. This will result in dangerous consequences that can be life-threatening.

Nitrazepam acts by binding itself to GABA receptors in the brain. GABA (gamma-aminobutyric acid) is a neurochemical that chiefly inhibits nerve excitement. The chemical works to reduce excitatory activities, that may result in anxiety, agitation, and lack of sleep. When nitrazepam binds to these receptors, it creates a backlog of GABA, which goes on to decrease brain activity more than normal.

Nitrazepam will help you to sleep. You will be prescribed a short course of treatment only. Take your dose just before you go to bed. The effects of nitrazepam can last into the following day; it is likely to impair your reactions and your ability to drive. Do not drive and do not use tools or machines while affected.

Poor sleep (insomnia) is fairly common but does not usually last for long. If you have problems sleeping, it may mean that you have difficulty getting off to sleep, or you may wake up for long periods during the night, or you may wake up too early in the morning. 'Sleeping tablets' like nitrazepam are considered a last resort, but are sometimes prescribed for a short period of time to help with a particularly bad spell of insomnia. Nitrazepam works by affecting the way certain brain chemicals (neurotransmitters) transmit messages. This has a calming effect which helps you to sleep. It works well in the short term, with one week's treatment normally being sufficient, although up to three weeks of treatment are sometimes required. If you take it for longer, the medicine can lose its effect (you may become tolerant to the effect) and when you stop it you may develop withdrawal symptoms. You may need to keep taking the medicine to avoid the withdrawal symptoms. This is known as drug dependence. In addition, you may become addicted to nitrazepam. Addiction is different from dependence. You have an overwhelming craving for a drug, so that you feel compelled to take it even though it is harming you physically or affecting your life and relationships.

How Alodorm works:
Alodorm contains the active ingredient nitrazepam, which belongs to a group of medicines called benzodiazepines. These medicines are thought to work by their action on brain chemicals. Nitrazepam exhibits sedative, anxiolytic, anticonvulsant and muscle relaxant effects. This is presumed to be the result of facilitating the action in the brain of gamma-aminobutyric acid (GABA), an endogenous inhibitor neurotransmitter. Taken in the evening in recommended doses, nitrazepam induces sleep lasting 6 to 8 hours.

Nitrazepam
Duration:

Hypnotic Benzodiazepine, that is used for short term relief of anxiety and insomnia. It has a pronouced affect on respritory action.

RouteOnsetDurationAfter Effects
Tripsit Factsheets
All ROAs:10-40 minutes5-8 hours6-12 hours
Nitrazepam Duration
Effects:
Anxiolytic, Sedative, Muscle Relaxant, Amnesia, Dystaxia, Hypnotic.

What forms does this medication come in?

5 mg Each white, round, flat-faced, bevelled-edged tablet, scored on one side and embossed "RHO 5" on the other side, contains nitrazepam 5 mg. Nonmedicinal ingredients: lactose, magnesium stearate, microcrystalline cellulose, and sodium croscarmellose.
10 mg Each white round, flat-faced, bevelled-edged tablet, scored on one side and embossed "RHO 10" on the other side, contains nitrazepam BP 10 mg. Nonmedicinal ingredients: lactose, magnesium stearate, microcrystalline cellulose, and sodium croscarmellose.

Warning:
Taking nitrazepam with opioid medications (such as codeine, hydrocodone) may increase your risk of very serious side effects, including death. To lower your risk, your doctor should have you take the smallest dose of nitrazepam that works, and take it for the shortest possible time. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.

What are the possible side effects of nitrazepam?
Your child may have some of these side effects while they take nitrazepam. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or if they bother your child:

  • dizziness or light-headedness
  • drowsiness
  • clumsiness or unsteadiness
  • slurred speech
  • blurred vision
  • dry mouth
Call your child's doctor during office hours if your child has any of these side effects:
  • yellow eyes or skin
  • unusual bruising or bleeding
  • unusual changes in behaviour
  • severe drowsiness/confusion
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:
  • new onset or worsening seizures
  • if your child shows signs of a life-threatening reaction, including: wheezing; trouble breathing; chest tightness; fever; itching; bad cough; blue skin colour; or swelling of the face, lips, tongue, or throat
  • slow heartbeat

Breastfeeding:

Summary of Use During Lactation:
Nitrazepam is not approved for marketing in the United States by the U.S. Food and Drug Administration. It is excreted into breastmilk in small amounts.

Because of its long half-life of about 30 hours, it may accumulate in the serum of breastfed infants with repeated doses.

Other agents are preferred, especially while nursing a newborn or preterm infant.

Alternate Drugs to Consider:

Nitrazepam has an intermediate half-life.
In sleep laboratory studies, nitrazepam decreased sleep latency, increased total sleep time and decreased awake time. There is delay in the onset, and decrease in the duration of REM sleep. Nitrazepam is reported to significantly decrease stage 1, 3 and 4 sleep and to increase stage 2. Following discontinuation of the drug, REM sleep rebound has been reported in some studies. Nitrazepam has been shown to raise the seizure threshold.


Nitrazepam (trade names: Alodorm, Apodorm, Arem, Mogadon, Nitrados, Nitrazadon, Nitrosun, Ormodon, Paxadorm, Remnos, and Somnite) is a hypnotic drug of the benzodiazepine class, indicated for the short-term relief of severe, disabling anxiety and insomnia. Nitrazepam has sedative and motor-impairing properties, as well as amnestic, anticonvulsant, and skeletal muscle relaxant effects. Nitrazepam is used to treat short-term sleeping problems (insomnia), namely difficulty falling asleep, frequent awakening, early awakening, or a combination of each. Nitrazepam is sometimes tried to treat epilepsy when other medications fail. It has been found to be more effective than clonazepam in the treatment of West syndrome, which is age-dependent epilepsy, affecting the very young. In uncontrolled studies, nitrazepam has shown effectiveness in infantile spasms and is sometimes considered when other anti-seizure drugs have failed. However, drowsiness, hypotonia, and most significantly tolerance to anti-seizure effects typically develop with long-term treatment, generally limiting Nitrazepam to acute seizure management. More common side effects may include: Central nervous system depression, including somnolence, dizziness, depressed mood, rage, violence, fatigue, ataxia, headache, vertigo, impairment of memory, impairment of motor functions, hangover feeling in the morning, slurred speech, decreased physical performance, numbed emotions, reduced alertness, muscle weakness, double vision, and inattention have been reported. Unpleasant dreams and rebound insomnia have also been reported. Nitrazepam is a long-acting benzodiazepine with an elimination half-life of 15 - 38 hours (mean elimination half-life 26 hours).

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Patented in 1961 and came into medical use in 1965. A hypnotic drug of the benzodiazepine class used for short-term relief from severe, disabling anxiety and insomnia. It also has sedative (calming) properties, as well as amnestic (inducing forgetfulness), anticonvulsant, and skeletal muscle relaxant effects. Nitrazepam is used to treat short-term sleeping problems (insomnia), namely difficulty falling asleep, frequent awakening, early awakening, or a combination of each. Nitrazepam is sometimes tried to treat epilepsy when other medications fail. Nitrazepam is not recommended for use in those under 18 years of age. Nitrazepam is not recommended during pregnancy. Elderly: Nitrazepam, similar to other benzodiazepines and nonbenzodiazepines, causes impairments in body balance and standing steadiness in individuals who wake up at night or the next morning. Falls and hip fractures are frequently reported. Combination with alcohol increases these impairments. Partial but incomplete tolerance develops to these impairments.

Nitrazepam has been found to be dangerous in elderly patients due to a significantly increased risk of falls.

  
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