Nitrazepam (marketed under the trade names Mogadon® , Nitredon ®, Nilandron® ) is a powerful hypnotic drug , which is a benzodiazepine derivative. It possesses powerful anxiolytic , anticonvulsant , sedative and skeletal muscle relaxant properties.

Nitrazepam shortens the time required to fall asleep and lengthens the duration of this sleep . Typically, it may work within an hour and allow the individual to maintain sleep for 4 to 6 hours.

How does it work?

Nitrazepam belongs to a group of medicines called benzodiazepines. It acts on receptors in the brain (GABA receptors) causing the release of a chemical called GABA (gamma amino butyric acid). GABA is a major inhibitory chemical in the brain involved in inducing sleepiness and control of anxiety and fits.

Nitrazepam acts by increasing the activity of GABA, thereby reducing the functioning of certain areas of the brain. This results in sleepiness, a decrease in anxiety and relaxation of muscles.

Nitrazepam is most commonly used to treat insomnia. It decreases the time taken to fall asleep and nocturnal awakenings, as well as increasing the total amount of time spent sleeping. As nitrazepam remains active in the body for many hours, drowsiness may occur the next day.

Warning!
This medicine is generally only suitable for short-term use. If it is used for long periods or in high doses, tolerance to and dependence upon the medicine may develop, and withdrawal symptoms may occur if treatment is stopped suddenly. For this reason, treatment with this medicine should usually be stopped gradually, following the instructions given by your doctor, in order to avoid withdrawal symptoms such as rebound insomnia or anxiety, confusion, sweating, tremor, loss of appetite, irritability or convulsions.

Use with caution in

• Breastfeeding
• Disease affecting the airways or lungs (respiratory disease)
• Elderly people
• History of alcoholism or drug abuse
• Kidney disease
• Life long inherited blood diseases which can cause a variety of symptoms, including mental health problems (porphyrias)
• Liver disease
• Muscle weakness
• Personality disorders
• Pregnancy

Not to be used in

• A sudden worsening of any underlying lung disease (acute pulmonary insufficiency)
• Abnormal muscle weakness (myasthenia gravis)
• Children
• Phobias or obsessional states
• Severe liver disease
• Slow, shallow breathing (respiratory depression)
• Syndrome involving short spells when breathing stops during sleep (sleep apnoea syndrome)
• Treatment as a single medication for depression or chronic psychosis

Side Effects

Side effects can include:

• Somnolence
• Impaired motor function
  • Impaired coordination
  • Impaired balance
  • Dizziness
• Amnesia
• Confusion
• Lack of concentration
• Headache , " hangover " feeling in the morning.

How can this medicine affect other medicines?

The following medicines may increase the sedative effect of nitrazepam:
Alcohol
Ritonavir
Probenecid
and sedating antihistamines such as chlorpheniramine.

There may be a decrease in blood nitrazepam levels when taken with rifampicin, making it less effective.
Nitrazepam may increase blood phenytoin levels.
The effectiveness of levodopa is decreased by nitrazepam.