Drug Index



Mechanism :

Nitrazepam is a benzodiazepine. Benzodiazepines presumably exert their effects by binding at stereo specific receptors at several sites within the central nervous system. All benzodiazepines cause a dose-related central nervous system depressant activity.

Indication :

• Infantile spasm

• Myoclonic seizures

• Periodic epileptic spasms after infancy

Contraindications :

Lorazepam is contraindicated in patients with hypersensitivity to benzodiazepines or to any components of the formulation, in acute narrow-angle glaucoma, pre-existing CNS depression, coma, acute pulmonary insufficiency or sleep apnea. Encephalopathy may be precipitated in patients with severe hepatic insufficiency.

Dosing :

Oral: Initially 0.25 mg/kg every 12 hourly doses followed by maintenance of 0.5 mg/kg every 12 hourly; Max: 1 mg/kg/day. Total daily dose may be given in 3 divided doses. Achieve target maintenance dose in 2-3 weeks.

Adverse Effect :

The common side effects seen are drowsiness, ataxia, irritability, light-headedness, dysarthria and disinhibition. Occasionally, confusion, hangover, headache, dizziness, blurred vision, depression and hallucinations have been seen. Withdrawal symptoms on long term usage: muscle cramps, tremor, irritability, convulsions and perceptual distortions.

Interaction :

CNS depressants: Anaesthetics, Opioids, Antihistamines, Baclofen, Barbiturates, Antipsychotics, Anxiolytics, Antidepressants: Enhanced effectiveness.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function. Start with small doses

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnknown dialysability. Dose as in GFR<10 mL/min
CAV/VVHDUnlikely to be dialysed. Dose as in normal renal function

Hepatic Dose :

Mild-to-moderate impairment: There are no dosage adjustments provided in the manufacturer’s labeling; use with caution.
Severe impairment: Use is contraindicated.
05/26/2020 08:12:50 Nitrazepam
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