Nitrazepam "dak" (Nitrazepam)

Nitrazepam is a benzodiazepine that acts on the central nervous system to modulate GABA activity.

• Insomnia: improves sleep onset and maintenance in patients with short‑term sleep disturbance.
• Anxiety disorders: reduces excessive anxiety, tension and associated autonomic symptoms.
• Epileptic seizures: helps control certain seizure types, particularly absence and myoclonic seizures, when used as adjunct therapy.

• Nitrazepam binds to an allosteric site on the GABA‑A receptor complex, increasing the frequency of chloride channel opening in response to GABA. This enhances chloride influx, hyperpolarising neuronal membranes and producing sedative, anxiolytic, muscle‑relaxant and anticonvulsant effects throughout the central nervous system.

Nitrazepam may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Drowsiness: feeling unusually sleepy during daytime activities.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Impaired coordination: reduced motor control affecting tasks such as driving.
• Memory impairment: difficulty recalling recent events.

Serious or Rare Side Effects

• Respiratory depression: slowed breathing that may be life‑threatening.
• Severe allergic reactions: rash, swelling, or anaphylaxis.
• Withdrawal seizures: seizures occurring after abrupt discontinuation.
• Mood changes: depression, suicidal thoughts, or paradoxical aggression.

When prescribing nitrazepam, clinicians should consider several safety measures.

• Dose adjustment in elderly: start with the lowest effective dose due to increased sensitivity.
• Avoid abrupt discontinuation: taper under medical supervision to prevent withdrawal phenomena.
• Use with caution in hepatic impairment: monitor plasma levels and clinical response.
• Avoid concomitant CNS depressants: increased risk of profound sedation and respiratory depression.
• Pregnancy and lactation: contraindicated; classified as Category D.
• Store at ambient temperature: keep below 25°C in the original container, protect from moisture and light.

Nitrazepam can interact with other medicines, altering its safety profile.

Major Interactions (Avoid)

• Opioids: additive respiratory depression and profound sedation.
• Alcohol: synergistic CNS depression leading to marked drowsiness.
• Other benzodiazepines: cumulative sedative effect and increased overdose risk.

Moderate Interactions (Monitor Closely)

• Antidepressants (SSRIs): may enhance sedation and dizziness.
• Antihistamines: increased drowsiness and impaired psychomotor performance.
• CYP3A4 inhibitors (e.g., erythromycin, ketoconazole): may raise nitrazepam plasma concentrations.