Disclaimer Notice:

Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

The information provided on Emedz.net is for doctors and pharmacists only to manage their patients in the best way and avoid medications-related errors.

Still, for the general population, this should not be considered professional medical advice or a substitute for consultation with a licensed healthcare provider. The content on this blog is not intended to diagnose, treat, cure, or prevent any disease or health condition.

Always seek the advice of a qualified healthcare professional before making any changes to your diet, exercise routine, medication, or any other aspect of your healthcare. We strongly discourage self-medication and self-treatment.

Even though the primary author of emedz.net is an experienced health professional, the blog is not intended to replace medical advice sought at the Doctor’s Clinic.

The authors share personal experiences, research findings, and general knowledge about health and wellness and medications-related topics.

However, individual health situations vary, and what works for one person may not work for another. It's important to consult with a healthcare provider for personalized guidance.

We strive to provide accurate and up-to-date information, but medical knowledge is constantly evolving. Therefore, we do not guarantee the accuracy, completeness, or timeliness of the information presented in this blog.

Emedz.net is not an online pharmacy:

Online pharmacies sell medicines and pharmaceutical products. EMEDZ.net is intended to provide drug-related information to pharmacists and physicians. It is intended to provide authentic information about medicines so as to prevent errors related to prescriptions.

We do not sell medicines, so please don’t ask for them.

We are not affiliated with any pharmaceutical companies:

Emedz.net has no affiliation with any pharmaceutical companies. We do not promote any product. Sometimes brand names are also mentioned in the title of the page, but that is what is called a “Featured Image”. It has nothing to do with selling or promoting that brand. Just to make things easier, generic and brands are mentioned in the blog.

Emedz.net may contain links to external websites or resources for your convenience. We do not endorse or take responsibility for the content of these external sites.

In no event shall Emedz.net, its authors, contributors, or any related parties be liable for any damages or consequences arising from the use of the information provided on this blog.

By using Emedz.net, you acknowledge and agree to this disclaimer and our Terms of Use. If you do not agree with this disclaimer or our Terms of Use, we advise you to refrain from using our website.

Remember, your health is a valuable asset, and decisions about your health should always be made in consultation with a qualified healthcare professional.

Nitrazepam (Alodorm) 5, 10 mg - Uses, Dose, Side effects

Nitrazepam (Alodorm, Mogadon) is a benzodiazepine drug that has strong sedative, amnestic, anticonvulsant, and anxiolytic properties. When used for the treatment of insomnia, its effects last for 6 to 8 hours.

Nitrazepam (Alodorm) Uses:

Note:

Not approved in the US
Insomnia:
- Insomnia, which is characterised by frequent nocturnal awakenings, trouble settling asleep, and early morning awakenings, can be treated and relieved temporarily.
Limitations of use:
- Restrict use to insomnia that impairs normal daytime functioning.
- Treatment should typically not exceed 7-10 consecutive days.
- If treatment continues for >2 to 3 consecutive weeks, reevaluation of the patient is required.
- Only a month's worth of medication should be prescribed for short-term (7 to 10 day) use.
Seizures:
- Managing myoclonic seizures

Nitrazepam (Alodorm) Dose in Adults

Nitrazepam (Alodorm) Dose in the treatment of Insomnia:

P/O:
5-10 milligram at bedtime.
Therapy shouldn't go longer than 7 to 10 days straight.
Usage for more than 2 to 3 weeks in a row necessitates a thorough reevaluation of the patient.

Nitrazepam (Alodorm) Dose in Children

Nitrazepam (Alodrom) Dose in the treatment of Myoclonic seizures:

Infants and Children ≤30 kg:
- P/O:
- Usual dosage:
- 0.3 to 1 milligram/kilogram/day in 3 equally divided doses.
- Administer larger dose at bedtime, If doses are not divided equally,

Note:

Therapy should be started and cautiously titrated based on response below the standard dosage range.
Gradually increase the dose further if there is an inadequate response to the usual dosage.
Manufacturer labeling does not specify a max dosage.

Nitrazepam Pregnancy Risk Category: D

It is not recommended to use during pregnancy.
Nitrazepam crosses over the human placenta.
Certain benzodiazepines have teratogenic side effects. Nonetheless, more study is required.
Low birth weights and premature births can be more common after maternal use of benzodiazepines.
After exposure late in pregnancy, hypoglycemia and respiratory problems may develop in the neonate.
Some benzodiazepines have been linked to neonatal withdrawal symptoms, which can occur as soon as days or weeks after birth.

Use of Nitrazepam while breastfeeding

Breast milk contains Nitrazepam.
There have been cases in which nursing infants experienced drowsiness, lethargy or weight loss after maternal use of some benzodiazepines.
According to the manufacturer, breastfeeding should not be done.

Nitrazepam Dose in Kidney Disease:

There are no dosage adjustments in the manufacturer's labeling.
Use caution.

Nitrazepam Dose in Liver disease:

Mild to moderate impairment
- There are no dosage adjustments in the manufacturer's labeling.
- Use caution.
Severe impairment
- Contraindicated.

Side effects of Nitrazepam (Alodorm):

Cardiovascular:
- Hypotension
- Palpitations
Central Nervous System:
- Aggressive Behavior
- Agitation
- Amnesia
- Ataxia
- Confusion
- Delusions
- Depression
- Disorientation
- Dizziness
- Excitement
- Falling
- Fatigue
- Hallucination
- Hangover Effect
- Headache
- Hyperactivity
- Irritability
- Lethargy
- Myasthenia
- Nervousness
- Nightmares
- Outbursts Of Anger
- Psychosis
- Restlessness
- Sedation
- Staggering
- Withdrawal Syndromer
Dermatologic:
- Dermatological Reaction
Endocrine & Metabolic:
- Change In Libido
Gastrointestinal:
- Constipation
- Diarrhea
- Heartburn
- Nausea
- Sialorrhea
- Vomiting
Hematologic & Oncologic:
- Granulocytopenia
- Leukopenia
Hepatic:
- Abnormal Hepatic Function Tests
Hypersensitivity:
- Anaphylaxis
Neuromuscular & Skeletal:
- Muscle Spasticity
Ophthalmic:
- Blurred Vision
Respiratory:
- Aspiration
- Dyspnea
- Increased Bronchial Secretions

Contraindications to Nitrazepam:

Hypersensitivity
Myasthenia gravis.
Severe respiratory impairment (eg, severe sleep apnea syndrome).
Severe hepatic impairment.
Use with children to hypnotize

Warnings and precautions

Anaphylaxis, anaphylactoid reactions
- Rarely reported as a result of use.
- Patients who have angioedema should not be given nitrazepam.
Anterograde amnesia
- Anterograde amnesia has been linked to benzodiazepines (Nelson 1999).
- If taken to induce sleep while on the road, may also cause transient global amnesia and traveler's amnesia.
- Patients should make sure they can get at least 7-8 hours of unbroken sleep after ingesting.
Aspiration pneumonia
- Rarely, patients with aspiration pneumonia can experience bronchial hypersecretion and excessive salivation/drooling.
Depression in the CNS:
- CNS depression can lead to mental or physical impairment.
- It is important to inform patients about tasks that require mental alertness, such as driving or operating machinery.
Paradoxical reactions
- Benzodiazepines have been associated with paradoxical effects.
- Patients with a history of alcohol abuse or psychiatric/personality disorders may be more likely to develop an alcohol-
- related disorder in adolescence or childhood or psychiatric/personality disorders.
Rebound insomnia
- After the withdrawal of therapy, transient insomnia can recur. This may be accompanied by anxiety, restlessness, mood changes, and other reactions.
Activities that are sleep-related:
- With benzodiazepines, hazardous sleep-related activities like sleep-driving and cooking while sleeping have been identified.
Depression
- Patients with depression should be cautious if there is a high risk of suicide.
Use of drugs:
- Patients with a history or alcoholism should be cautious.
- Drug dependency is possible.
- Prolonged use can lead to tolerance, psychological reliance, and/or physical dependence.
Hepatic impairment
- Patients with severe hepatic impairment should be cautious.
Renal impairment
- Use caution in patients with impaired renal function.
Respiratory disease
- Patients with severe respiratory problems should be cautious.

Nitrazepam (United States: Not available): Drug Interaction

Risk Factor C (Monitor therapy)
Alcohol (Ethyl)	CNS Depressants may enhance the CNS depressant effect of Alcohol (Ethyl).
Alizapride	May enhance the CNS depressant effect of CNS Depressants.
Brexanolone	CNS Depressants may enhance the CNS depressant effect of Brexanolone.
Brimonidine (Topical)	May enhance the CNS depressant effect of CNS Depressants.
Bromopride	May enhance the CNS depressant effect of CNS Depressants.
Cannabidiol	May enhance the CNS depressant effect of CNS Depressants.
Cannabis	May enhance the CNS depressant effect of CNS Depressants.
Chlorphenesin Carbamate	May enhance the adverse/toxic effect of CNS Depressants.
CNS Depressants	May enhance the adverse/toxic effect of other CNS Depressants.
Cosyntropin	May enhance the hepatotoxic effect of Nitrazepam.
Dimethindene (Topical)	May enhance the CNS depressant effect of CNS Depressants.
Doxylamine	May enhance the CNS depressant effect of CNS Depressants. Management: The manufacturer of Diclegis (doxylamine/pyridoxine), intended for use in pregnancy, specifically states that use with other CNS depressants is not recommended.
Dronabinol	May enhance the CNS depressant effect of CNS Depressants.
Esketamine	May enhance the CNS depressant effect of CNS Depressants.
Fosphenytoin	Benzodiazepines may increase the serum concentration of Fosphenytoin. Shortterm exposure to benzodiazepines may not present as much risk as chronic therapy.
HydrOXYzine	May enhance the CNS depressant effect of CNS Depressants.
Kava Kava	May enhance the adverse/toxic effect of CNS Depressants.
Lofexidine	May enhance the CNS depressant effect of CNS Depressants. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs.
Magnesium Sulfate	May enhance the CNS depressant effect of CNS Depressants.
Melatonin	May enhance the sedative effect of Benzodiazepines.
MetyroSINE	CNS Depressants may enhance the sedative effect of MetyroSINE.
Minocycline	May enhance the CNS depressant effect of CNS Depressants.
Mirtazapine	CNS Depressants may enhance the CNS depressant effect of Mirtazapine.
Nabilone	May enhance the CNS depressant effect of CNS Depressants.
Phenytoin	Benzodiazepines may increase the serum concentration of Phenytoin. Short-term exposure to benzodiazepines may not present as much risk as chronic therapy.
Piribedil	CNS Depressants may enhance the CNS depressant effect of Piribedil.
Pramipexole	CNS Depressants may enhance the sedative effect of Pramipexole.
ROPINIRole	CNS Depressants may enhance the sedative effect of ROPINIRole.
Rotigotine	CNS Depressants may enhance the sedative effect of Rotigotine.
Rufinamide	May enhance the adverse/toxic effect of CNS Depressants. Specifically, sleepiness and dizziness may be enhanced.
Selective Serotonin Reuptake Inhibitors	CNS Depressants may enhance the adverse/toxic effect of Selective Serotonin Reuptake Inhibitors. Specifically, the risk of psychomotor impairment may be enhanced.
Teduglutide	May increase the serum concentration of Benzodiazepines.
Tetrahydrocannabinol	May enhance the CNS depressant effect of CNS Depressants.
Tetrahydrocannabinol and Cannabidiol	May enhance the CNS depressant effect of CNS Depressants.
Trimeprazine	May enhance the CNS depressant effect of CNS Depressants.
Yohimbine	May diminish the therapeutic effect of Antianxiety Agents.
Risk Factor D (Consider therapy modification)
Blonanserin	CNS Depressants may enhance the CNS depressant effect of Blonanserin.
Buprenorphine	CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants.
Chlormethiazole	May enhance the CNS depressant effect of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used.
CloZAPine	Benzodiazepines may enhance the adverse/toxic effect of CloZAPine. Management: Consider decreasing the dose of (or possibly discontinuing) benzodiazepines prior to initiating clozapine.
Droperidol	May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Exceptions to this monograph are discussed in further detail in separate drug interaction monographs.
Flunitrazepam	CNS Depressants may enhance the CNS depressant effect of Flunitrazepam.
HYDROcodone	CNS Depressants may enhance the CNS depressant effect of HYDROcodone. Management: Avoid concomitant use of hydrocodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
Methadone	Benzodiazepines may enhance the CNS depressant effect of Methadone. Management: Clinicians should generally avoid concurrent use of methadone and benzodiazepines when possible; any combined use should be undertaken with extra caution.
Methotrimeprazine	CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce adult dose of CNS depressant agents by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose is established.
Opioid Agonists	CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
OxyCODONE	CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
Perampanel	May enhance the CNS depressant effect of CNS Depressants. Management: Patients taking perampanel with any other drug that has CNS depressant activities should avoid complex and high-risk activities, particularly those such as driving that require alertness and coordination, until they have experience using the combination.
RifAMPin	May decrease the serum concentration of Nitrazepam. Management: Monitor closely for reduced effects of nitrazepam. When possible, consider alternatives to one of these drugs, or increases in initial nitrazepam doses.
Suvorexant	CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended.
Tapentadol	May enhance the CNS depressant effect of CNS Depressants. Management: Avoid concomitant use of tapentadol and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug.
Theophylline Derivatives	May diminish the therapeutic effect of Benzodiazepines.
Zolpidem	CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol.
Risk Factor X (Avoid combination)
Azelastine (Nasal)	CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal).
Bromperidol	May enhance the CNS depressant effect of CNS Depressants.
OLANZapine	May enhance the adverse/toxic effect of Benzodiazepines. Management: Avoid concomitant use of parenteral benzodiazepines and IM olanzapine due to risks of additive adverse events (e.g., cardiorespiratory depression). Olanzapine prescribing information provides no specific recommendations regarding oral administration.
Orphenadrine	CNS Depressants may enhance the CNS depressant effect of Orphenadrine.
Oxomemazine	May enhance the CNS depressant effect of CNS Depressants.
Paraldehyde	CNS Depressants may enhance the CNS depressant effect of Paraldehyde.
Sodium Oxybate	Benzodiazepines may enhance the CNS depressant effect of Sodium Oxybate.
Thalidomide	CNS Depressants may enhance the CNS depressant effect of Thalidomide.

Monitoring parameters:

Respiratory, cardiovascular, and mental status

How to administer Nitrazepam (Alodorm)?

P/O:

Tablets can be dissolved, crumbled, or eaten whole when mixed with fluids.
For insomnia, take before bed.
Provide a higher dose at bedtime if doses are not evenly divided, or give 3 equally spaced doses to treat myoclonic seizures.

Mechanism of action of Nitrazepam (Alodorm):

There are numerous locations in the Brain where nitrazepam can bind to stereospecific benzodiazepine receptors on postsynaptic GABA neurons, including the limbic system and the reticular formation.
Increased neuronal membrane permeability for chloride ions results in an increase in neuronal excitability, which enhances the inhibitory effects of GABA.
This is a shift in the chloride ions that results in hyperpolarization (a state less excitable) and stabilization.
The GABA-A receptors appear to be responsible for benzodiazepine effects and receptors.
Benzodiazepines don't bind to GABAB receptors.

The onset of action:

20-50 minutes

Absorption:

Rapid

Distribution:

Distributes into CSF, saliva (Kangas, 1979)

Protein binding:

87 percent

Metabolism:

Hepatic: Nitroreduction, acetylation.
no active metabolites

Bioavailability:

~80 percent

Half-life elimination:

30 hours (range: 18-57 hours),
Elderly/ill patients: 40 hours

Time to peak, plasma:

~3 hours

Excretion:

Urine (65 percent to 71 percent, ~1 percent as unchanged drug).
Feces (14 percent to 20 percent)

International Brands of Nitrazepam:

APO-Nitrazepam
Mogadon
SANDOZ Nitrazepam
Alodorm
Apodorm
Arem
Cerson
Dumolid
Epam
Eunoctin
Hypnol
Hypnotex
Imeson
Insomin
Mogadan
Mogadon
Mozepam
Nitavan
Nitrados
Nitrapan
Nitravet
Nitredon
Nitrom
Nitrosun
Noctin
Novanox
Octon
Ormodon
Pacisyn
Paxadorm
Radedorm
Sleepin

Nitrazepam Brand Names in Pakistan:

Nitrazepam Tablets 5 mg
Mogadon	Roche Pakistan Ltd.

Disclaimer Notice:

Emedz.net is not an online pharmacy:

We are not affiliated with any pharmaceutical companies:

Nitrazepam (Alodorm) 5, 10 mg - Uses, Dose, Side effects

Nitrazepam (Alodorm) Uses:

Insomnia:

Seizures:

Nitrazepam (Alodorm) Dose in Adults

Nitrazepam (Alodorm) Dose in the treatment of Insomnia:

Nitrazepam (Alodorm) Dose in Children

Nitrazepam (Alodrom) Dose in the treatment of Myoclonic seizures:

Infants and Children ≤30 kg:

Nitrazepam Pregnancy Risk Category: D

Use of Nitrazepam while breastfeeding

Nitrazepam Dose in Kidney Disease:

Nitrazepam Dose in Liver disease:

Side effects of Nitrazepam (Alodorm):

Cardiovascular:

Central Nervous System:

Dermatologic:

Endocrine & Metabolic:

Gastrointestinal:

Hematologic & Oncologic:

Hepatic:

Hypersensitivity:

Neuromuscular & Skeletal:

Ophthalmic:

Respiratory:

Contraindications to Nitrazepam:

Warnings and precautions

Anaphylaxis, anaphylactoid reactions

Anterograde amnesia

Aspiration pneumonia

Depression in the CNS:

Paradoxical reactions

Rebound insomnia

Activities that are sleep-related:

Depression

Use of drugs:

Hepatic impairment

Renal impairment

Respiratory disease

Monitoring parameters:

How to administer Nitrazepam (Alodorm)?

Mechanism of action of Nitrazepam (Alodorm):

International Brands of Nitrazepam:

Nitrazepam Brand Names in Pakistan:

Nitrazepam Tablets 5 mg

Recent Posts

Related Posts