Nitrazepam

Products

Nitrazepam is commercially available in tablet form (Mogadon). It has been approved in many countries since 1965.

Structure and properties

Nitrazepam (C15H11N3O3, Mr = 281.3 g/mol) is a nitrated 1,4-benzodiazepine. It exists as a yellow crystalline powder that is practically insoluble in water. Nitrazepam is structurally closely related to flunitrazepam (Rohypnol).

Effects

Nitrazepam (ATC N05CD02) has sleep-inducing, muscle-relaxing, and anticonvulsant properties. The effects are due to binding to GABA-A receptors and enhancing the inhibitory effects of GABA-ergic transmission.

Indications

For short-term treatment of sleep disorders and epilepsy (West, Lennox syndrome).

Abuse

Nitrazepam, like other benzodiazepines, can be abused as a depressant narcotic.

Dosage

According to the prescribing information. For the treatment of sleep disorders, the tablets are taken before bedtime.

Contraindications

  • Hypersensitivity, including to other benzodiazepines.
  • Myasthenia gravis
  • History of drug, narcotic or alcohol dependence in the patient.
  • Severe respiratory disorders
  • Sleep apnea syndrome
  • Severe hepatic insufficiency
  • Ataxia
  • Acute intoxication with intoxicants or drugs.

Full precautions can be found in the drug label.

Interactions

Drug-drug interactions are possible with central depressant drugs, muscle relaxants, alcohol, and CYP inhibitors.

Adverse effects

Possible adverse effects include psychiatric disturbances, paradoxical reactions, fatigue, drowsiness, anterograde amnesia, visual disturbances, respiratory depression, and digestive disturbances. Nitrazepam can be addictive and cause withdrawal symptoms upon discontinuation.