Nitrazepam
Class: Benzodiazepine (sedative-hypnotic, anticonvulsant)
Indications
- Short-term management of insomnia
- Adjunctive therapy for certain seizure disorders (e.g., myoclonic seizures)
- Occasionally used for anxiety disorders (short-term)
Mechanism of Action
- Enhances effect of GABA at GABA-A receptors
- Produces CNS depression, sedation, anxiolysis, and anticonvulsant effects
Dosage
- Adults (insomnia): 5–10 mg orally at bedtime
- Children: Usually 0.5–1 mg/kg/day for seizure management, divided doses
- Use the lowest effective dose for the shortest duration
Major Side Effects
- Drowsiness, sedation, lethargy
- Dizziness, ataxia
- Memory impairment, confusion (especially in elderly)
- Paradoxical reactions (agitation, excitement)
- Dependence and withdrawal symptoms with prolonged use
Contraindications
- Hypersensitivity to nitrazepam or other benzodiazepines
- Severe respiratory insufficiency
- Sleep apnea
- Severe hepatic impairment
- Myasthenia gravis
Compatible Solvent / Administration
- Oral tablets
- Take at bedtime; avoid alcohol or CNS depressants
Special Precautions
- Use short-term only to avoid dependence
- Monitor elderly for excessive sedation and risk of falls
- Avoid abrupt discontinuation after long-term use
- Pregnancy Category D – avoid unless benefits outweigh risks
Key Point: Nitrazepam is a benzodiazepine mainly for insomnia and seizure adjunct therapy; careful monitoring is needed due to sedation, dependence, and cognitive effects.