Nitrazepam is only found in individuals that have used or taken this drug. It is a benzodiazepine derivative used as an anticonvulsant and hypnotic. Nitrazepam belongs to a group of medicines called benzodiazepines. It acts on benzodiazepine receptors in the brain which are associated with the GABA receptors causing an enhanced binding of GABA (gamma amino butyric acid) to GABAA receptors. GABA is a major inhibitory neurotransmitter in the brain, involved in inducing sleepiness, muscular relaxation, and control of anxiety and fits, and slows down the central nervous system. The anticonvulsant properties of nitrazepam and other benzodiazepines may be in part or entirely due to binding to voltage-dependent sodium channels rather than benzodiazepine receptors. Sustained repetitive firing seems to be limited by benzodiazepines effect of slowing recovery of sodium channels from inactivation.
Nitrazepam is a type of benzodiazepine drug. It is a powerful hypnotic drug which possesses strong sedative, anxiolytic, amnestic, anticonvulsant, and skeletal muscle relaxant properties. Nitrazepam shortens the time required to fall asleep and lengthens the duration of sleep. It is also useful for the management of myoclonic seizures.
Mechanism of action of Nitrazepam
Nitrazepam belongs to a group of medicines called benzodiazepines. It acts on benzodiazepine receptors in the brain which are associated with the GABA receptors causing an enhanced binding of GABA (gamma amino butyric acid) to GABAA receptors. GABA is a major inhibitory neurotransmitter in the brain, involved in inducing sleepiness, muscular relaxation and control of anxiety and fits, and slows down the central nervous system. The anticonvulsant properties of nitrazepam and other benzodiazepines may be in part or entirely due to binding to voltage-dependent sodium channels rather than benzodiazepine receptors. Sustained repetitive firing seems to be limited by benzodiazepines effect of slowing recovery of sodium channels from inactivation.
Indications of Nitrazepam
- Sleeplessness
- Myoclonic seizures
- Treatment of short-term sleeping problems (insomnia)
- Epilepsy
- Frequent awakenings during the night
- Early-morning awakening.
- Used to treat short-term sleeping problems (insomnia), such as difficulty falling asleep, frequent awakenings during the night, and early-morning awakening.
Contra-Indications of Nitrazepam
- Early-morning awakening.
- Myasthenia gravis,
- Narrow-angle glaucoma,
- Severe respiratory insufficiency,
- Sleep apnoea syndrome,
- Severe hepatic impairment,
- Porphyria.
- Allergic to nitrazepam or any ingredients of this medication
- Allergic to other benzodiazepines
Dosages of Nitrazepam
Strength: 5mg; 10 mg; 25mg
Adults
- 5mg before going to bed, your doctor may increase this up to 10mg.
Elderly and debilitated patients
- 2.5-5mg before going to bed. It is particularly important to take this medicine exactly as directed by the doctor.
Infantile spasms
- Child: Infants: 125 mcg/kg bid; gradually increase to 250-500 mcg/kg bid.
Children under 12 years: Not recommended.
Side Effects of Nitrazepam
The most common
- clumsiness or unsteadiness
- dizziness
- drowsiness
- dry mouth
- false sense of well-being
- increased watering of mouth
- lightheadedness
- constipation;
- vision changes;
- breast swelling (in men or women); or
- decreased sex drive, impotence, or difficulty having an orgasm.
- blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
- restless muscle movements in your eyes, tongue, jaw, or neck;
- a light-headed feeling, like you might pass out;
Common
- Drowsiness and lightheadedness the day after taking the medicine.
- Confusion.
- Numbed emotions.
- Visual disturbances such as blurred vision or double vision.
- Shaky movements and unsteady walk (ataxia).
- Loss of memory (amnesia).
- Muscle weakness.
- Dizziness.
- Headache.
- Skin rashes.
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.
- Difficulty in passing urine (urinary retention).
- Changes in sex drive.
- Low blood pressure (hypotension).
- Blood disorders.
- Jaundice.
- Unexpected aggression, restlessness or irritability (tell your doctor if you experience this).
- Nightmares or hallucinations (tell your doctor if you experience this).
Serious
- agitation
- anxiety
- behavioural changes, including aggressiveness, angry outbursts, bizarre behavior, or decreased inhibitions
- confusion
- increased trouble sleeping
- memory problems
- muscle spasms
- shortness of breath
- signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
- sleepwalking
Drug Interactions of Nitrazepam
Nitrazepam may interact with following drugs, Supplements & may change the efficacy of drugs
- anticonvulsants (e.g., carbamazepine, gabapentin, levetiracetam, phenytoin, topiramate)
- antihistamines that cause drowsiness (e.g., chlorpheniramine, dimenhydrinate, diphenhydramine)
- antipsychotic medications (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- aripiprazole
- azole antifungal medications (e.g., fluconazole, ketoconazole)
- baclofen
- barbiturates (e.g., phenobarbital, secobarbital)
- other benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
- birth control pills
- calcium channel blockers (e.g., diltiazem, nifedipine, verapamil)
- carbamazepine
- cimetidine
- gabapentin
- mirtazapine
- muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
- phenytoin
- proton pump inhibitors (PPIs; e.g., omeprazole, pantoprazole)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, paroxetine, sertraline)
- tapentadol
- theophylline
- tramadol
- tricyclic antidepressants (e.g., amitriptyline, imipramine)
Pregnancy & Lactation of Nitrazepam
FDA Pregnancy Category D
Pregnancy
Nitrazepam, like other benzodiazepines, can cause harm to an unborn baby if the mother takes it while pregnant. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Lactation
This medication passes into breast milk. If you are a breastfeeding mother and are taking nitrazepam, it may affect your baby. Talk to your doctor about whether you should continue breastfeeding. The safety and effectiveness of nitrazepam for sleep difficulties have not been established for children and adolescents less than 18 years of age.
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