 Other names: Mogadon (Canadian brand name)
About Nitrazepam
Nitrazepam is a sedative used to treat insomnia. Nitrazepam is in the group of drugs known as benzodiazepines, a class of antidepressants, anti-panic agents, and muscle relaxants. Nitrazepam is usually used as a short term treatment for temporary insomnia, but if used daily, it will become ineffective in a few weeks. This medication has some anticonvulsant properties, but US prescribing guidelines are unavailable for this use.
Nitrazepam is only available by prescription in Canada, do not use with narcotic pain medications, alcohol, or other sedatives.
Nitrazepam Side Effects
Nitrazepam side effects are usually temporary, and fade with continued treatment. Higher dosage also increases the risk of side effects. Operating automobiles or heavy machinery is not recommended while taking Nitrazepam, which should be taken before bedtime only when you know you can have a full night's rest. Be aware of how this medication affects you before attempting any potentially dangerous activities.
Expected Nitrazepam side effect: Drowsiness.
Common Nitrazepam side effects: Fatigue or grogginess the next morning, light-headedness, rebound insomnia (on stopping treatment), slurred speech.
Less common Nitrazepam side effects: abdominal cramps, anxiety, constipation, dry mouth, hyperventilation, blurred vision, nausea, chest pain, change in sex drive, confusion, depression, headache, change in appetite, insomnia, unusual dreams, change in salivation, low blood pressure, racing heartbeat, fainting, nasal congestion, sweating, weight change, skin irritation, twitching or tremors, nervous or anxious state, sun sensitivity, respiratory infection, memory impairment, menstrual difficulties, and loss of coordination. Speak to your doctor about any of these effects; your dosage may need to be adjusted or treatment discontinued.
Rare Nitrazepam side effects: difficulty concentrating, slurred or unusual speech, delusions, double vision, fear, altered sense of taste, lack of inhibition, muscle cramps or spasms, urination problems or incontinence, tingling, seizure, sores in mouth, warmth, weakness, change in muscle tone, uncontrolled movements, or yellow eyes and skin. Speak to your doctor if you experience any of these effects; your treatment may need to be discontinued, or you may require medical attention.
Nitrazepam treatment should be discontinued if any of the following occur: hyperexcitement, muscle spasm, anxiety, hallucinations, rage or other hostile behavior, tremors, insomnia, sleeping difficulties or overstimulation.
Cautions: Nitrazepam has been known to interact undesirably with certain medical conditions. Tell your doctor if you have, or have a history of, any of the following conditions:
- Alcohol or drug abuse - may increase likelihood of Nitrazepam dependence
- Allergic reaction to Nitrazepam, or other benzodiazepine. Always tell your doctor about any allergies before starting a medication.
- Borderline personality disorder or a history of violent behavior.
- Brain disease - may increase likelihood of side effects from Nitrazepam
- Breathing difficulties such as asthma, bronchitis, emphysema, or any other chronic lung disease - Nitrazepam may worsen this condition.
- Difficulty swallowing - This condition may become more pronounced in children.
- Epilepsy or seizures - Abruptly starting or stopping treatment with Nitrazepam may increase seizures. Although Nitrazepam can be used as an aid to anti-tremor therapy, it should be used cautiously and strictly according to a doctor's instructions in these cases.
- Glaucoma - Nitrazepam should not be prescribed to patients with acute narrow-angle glaucoma. Patients receiving treatment for open angle glaucoma should consult their doctor, as Nitrazepam may be an acceptable treatment for them.
- Hyperactivity
- Kidney or liver problems - In isolated cases, Nitrazepam has been reported to cause jaundice. If you experience yellowing of the skin or eyes, seek medical treatment immediately. More Nitrazepam may end up in your bloodstream if you have a pre-existing kidney or liver condition, increasing the likelihood of side effects.
- Major Depression
- Myasthenia gravis - This autoimmune disorder characterized by muscle weakness may be aggravated by Nitrazepam treatment.
- Porphyria - Nitrazepam (alprazolam) is listed as an unsafe drug for porphyria, an enzyme deficiency that can cause fragile skin that is sensitive to sunlight, digestive difficulties, anxiety, and reddish-brown urine.
- Psychosis or other serious mental illness - Nitrazepam has not proved to be an effective treatment for these conditions, and is not recommended.
- Sleep apnea (temporary suspension of breathing during sleep) - Nitrazepam may worsen this condition. Individuals with sleep apnea should not generally use sedatives as sleep aids.
Dependence: Nitrazepam has been known to be habit-forming. Withdrawal symptoms may occur if treatment is discontinued abruptly. Follow your doctor's advice about how much, and how often, you should take Nitrazepam. If you are considering stopping Nitrazepam treatment, ask your doctor how to safely decrease and then stop Nitrazepam.
Nitrazepam Interactions
Nitrazepam slows the central nervous system, and should be taken with care with medications that do the same thing. When Nitrazepam is taken with certain other medications, the rate of side effects may increase, and the action of either medication may be increased or altered. Certain medications can cause an undesirable build-up of Nitrazepam in the body. Ask your doctor's advice about combining Nitrazepam with any of the following:
- Alcohol - Nitrazepam should not be mixed with alcohol, it increases the risk of overdose and fatal toxicity.
- Any medication which may cause drowsiness
- Antibiotics (esp. macrolide antibiotics) like azithromycin, biaxin, clarythromycin, or erythromycin
- Antihistamines like Tavist or Benadryl
- Adalat, Procardia (nifedipine)
- Antabuse (disulfiram)
- Antifungals like Diflucan (fluconazole), Nizoral (ketoconazole), Sporanox (itraconazole), and possibly others may increase the effects of this medication. Do not combine these treatments, dangerous toxicity may result.
- Antiseizure medication like Cerebyx (fosphenytoin), Dilantin (phenytoin), or Tegretol (carbamazepine).
- Benzodiazepines of any other type, such as Valium (diazepam), Halcion (triazolam), Restoril (temazepam), Librium (chlordiazepoxide), Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam), Klonopin (clonazepam)
- BuSpar (buspirone) - Can result in oversedation.
- Cardene (nicardipine)
- Cordarone (amiodarone)
- Desyrel (trazodone) - Risk of additive CNS depression.
- Ergotamine derivatives
- Kava kava - Do not take this herb while taking Nitrazepam.
- MAO inhibitors such as the antidepressants Nardil or Parnate.
- Narcotic analgesics of any kind, like Darvon (propoxyphene), Darvocet (propoxyphene, acetaminophen), Demerol (meperidine), Codeine, Percocet (oxycodone, acetaminophen), Vicodin (hydrocodone, acetaminophen), Vicoprofen (hydrocodone and ibuprofen) or OxyContin (oxycodone) may accelerate central nervous system or respiratory depression when taken with Nitrazepam. Also, Nitrazepam may decrease the effectiveness of these medications as pain relievers.
- Norflex (orphenadrine) - Risk of oversedation.
- Neoral, Sandimmune (cyclosporine)
- Nicotine - Heavy smoking may reduce the effectiveness of your treatment.
- Oral contraceptives - May increase the effects of Nitrazepam.
- Prilosec (omeprazole) - May increase the effects of Nitrazepam.
- Rescriptor (delavirdine)
- Rifamate (isoniazid), Rifater (rifampin), or Mycobutin (rifabutin)
- Sedatives like Fioricet (butalbital, acetaminophen, and caffeine), Fiorinal (butalbital, aspirin, and caffeine), Phenobarbitol, Seconal, or other barbiturates
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa (citalopram), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline).
- Serzone (nefazodone)
- Skeletal muscle relaxants such as Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Soma (carisoprodol), or Robaxin (methocarbamol) may cause oversedation in combination with this medication.
- Sleep medication like Ambien (zolpidem), Sonata (zaleplon), or over the counter sleeping pills should be used with Nitrazepam only as, and if, advised by your doctor.
- Street drugs - Marijuana may increase sedative effects from Nitrazepam.
- St. John's Wort - Do not take this herb while taking Nitrazepam.
- Tagamet (cimetidine)
- Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine), or Thorazine (chlorpromazine) may cause oversedation.
- Tricyclic antidepressants such as Elavil (amitriptyline), Asendin (amoxapine), Anafranil (clomipramine), Pertofrane or Norpramin (desipramine), Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine), may increase the risk of side effects from Nitrazepam.
- Ultram (tramadol) - May increase the risk of oversedation, and lower the threshold for seizure.
- Valerian - Do not take this herb while taking Nitrazepam.
Talk with your doctor if you are considering mixing a sedative medication like Nitrazepam with any other antidepressant, or any medication that may cause drowsiness. Some medications can have increased, unexpected, or severe side effects when mixed with others that affect the central nervous system. Stimulants of any type may blunt the effectiveness of Nitrazepam.
Nitrazepam Dosages
Nitrazepam comes in tablets, and may be prescribed in dosages of 5-10 mg at bedtime. Follow the directions on your prescription exactly.
Nitrazepam Directions
Nitrazepam should be taken exactly as your doctor recommends. Don't take more or less than prescribed, and don't double your doses if you should miss one. Take your doctor's advice about how quickly or slowly to ease off Nitrazepam treatment if you plan to stop taking it. Nitrazepam should not be started or stopped abruptly, as it strongly increases the likelihood of side effects.
Inform your doctor, dentist, or anesthesiologist that you are taking Nitrazepam before any kind of surgery or medical test. This medication may interfere with certain test results. Nitrazepam should not be combined with certain medications given during surgery.
Store Nitrazepam away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.
Keep Nitrazepam away from children; both when storing it, and when discarding any unused medication.
Nitrazepam may cause drowsiness or disorientation. Be cautious if you plan to drive or operate heavy machinery, avoid these activities if you find yourself feeling tired or experience slowed reactions.
Nitrazepam and Pregnancy
Nitrazepam is not recommended for women who are breastfeeding, pregnant, or planning to become pregnant. Nitrazepam could cause breathing problems or muscle weakness in an infant. Also, a newborn whose mother had been taking Nitrazepam might experience withdrawal symptoms.
Other benzodiazepines, similar to Nitrazepam, have been seen to cause an increase in birth defects. While Nitrazepam has not been demonstrated to be a high risk factor for birth defects, the possibility exists that it could increase their likelihood.
Nitrazepam and Children
Nitrazepam has been used to treat seizures in children, but there are no US prescription guidelines.
Nitrazepam and Seniors
Older adults taking Nitrazepam are usually encouraged to start with smaller doses of no more than 2.5 mg at bedtime, and limit intake to the smallest effective dose. Seniors are more likely to become too heavily sedated, or experience decreased muscle coordination.
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