Long-acting hypnotic·Neurology - Sedatives & Hypnotics

Nitrazepam

Short-term treatment of severe insomnia

Authority requiredPBSBENZOMogadon, Alodorm5 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

10 mg/day

Half-life

15-38 h

Caution: Hangover

SEVERE

High risk: Elderly

AVOID

Cautions

Avoid / Cautions

Severe respiratory failure, Myasthenia Gravis, severe hepatic impairment.

Where it stands

Rapid Summary

Overview

Long-acting benzodiazepine hypnotic. Induces sleep effectively but possesses an excessively long half-life, causing a massive, functionally impairing next-day hangover.

Clinical Focus

Highly toxic in the elderly. Will accumulate over successive nights, leading to profound daytime sedation, delirium, and fractured hips.

Bottom Line

Nitrazepam is a long-acting benzodiazepine hypnotic, but accumulates in elderly causing excessive daytime sedation and falls, and has been largely replaced by shorter-acting agents.

Formulation & Access

Brand Names

Mogadon, Alodorm

Oral Routes

Tablets (5 mg).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Short-term treatment of severe insomnia.

Off-Label

OFF

Infantile spasms (West syndrome - rare pediatric epilepsy use).

Clinical Place

Largely obsolete for insomnia. Outperformed by Temazepam (short half-life) or Z-drugs for safety and hangover profiles.

Quick reference

Class & Role

Long-acting hypnotic — Long-acting benzodiazepine hypnotic.

Route / Formulation

Tablets (5 mg). (Mogadon, Alodorm)

Usual Dose & Max

PO 5-10 mg NOCTE (Take 30-60 mins before bed). Max 10 mg/day (Normally 5 mg NOCTE).

Key Indication Doses

Severe Insomnia: PO 5-10 mg NOCTE (Take 30-60 mins before bed). Elderly / Frail: Avoid entirely. If forced, max 2.5 - 5 mg. (Temazepam is vastly superior).

Best Uses

Nitrazepam is a long-acting benzodiazepine hypnotic, but accumulates in elderly causing excessive daytime sedation and falls, and has been largely replaced by shorter-acting agents.

Key Risks

Neurological: Next-day hangover (cognitive blunting, lethargy, ataxia). HIGH — Tolerance, dependence, withdrawal seizures if stopped abruptly after chronic use. Respiratory: Exacerbates obstructive sleep apnea (OSA) and respiratory failure.

Key Interactions

Opioids, Alcohol (Fatal respiratory arrest). CYP3A4 inhibitors (Clarithromycin, Azoles) prolong half-life further.

Monitoring

Advise the patient strictly not to drive the morning after taking Nitrazepam. Their reaction times will be identical to a drunk driver.

Clinical Pearl

If a patient takes 5mg every night, because the half-life is 30 hours, they haven't cleared yesterday's dose before they take today's dose. By Day 5, they functionally have 15mg in their system and are comatose during the day. Avoid for sequential nightly use.

Access

Authority requiredMogadon, Alodorm5 mg tablet

Brand: Mogadon, Alodorm
PBS status: Authority required
Formulation: Tablets (5 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Long-acting hypnotic·Neurology - Sedatives & Hypnotics

Nitrazepam

Short-term treatment of severe insomnia

Authority requiredPBSBENZOMogadon, Alodorm5 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

10 mg/day

Half-life

15-38 h

Caution: Hangover

SEVERE

High risk: Elderly

AVOID

Cautions

Avoid / Cautions

Severe respiratory failure, Myasthenia Gravis, severe hepatic impairment.

Where it stands

Rapid Summary

Overview

Long-acting benzodiazepine hypnotic. Induces sleep effectively but possesses an excessively long half-life, causing a massive, functionally impairing next-day hangover.

Clinical Focus

Highly toxic in the elderly. Will accumulate over successive nights, leading to profound daytime sedation, delirium, and fractured hips.

Bottom Line

Nitrazepam is a long-acting benzodiazepine hypnotic, but accumulates in elderly causing excessive daytime sedation and falls, and has been largely replaced by shorter-acting agents.

Formulation & Access

Brand Names

Mogadon, Alodorm

Oral Routes

Tablets (5 mg).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Short-term treatment of severe insomnia.

Off-Label

OFF

Infantile spasms (West syndrome - rare pediatric epilepsy use).

Clinical Place

Largely obsolete for insomnia. Outperformed by Temazepam (short half-life) or Z-drugs for safety and hangover profiles.

Quick reference

Class & Role

Long-acting hypnotic — Long-acting benzodiazepine hypnotic.

Route / Formulation

Tablets (5 mg). (Mogadon, Alodorm)

Usual Dose & Max

PO 5-10 mg NOCTE (Take 30-60 mins before bed). Max 10 mg/day (Normally 5 mg NOCTE).

Key Indication Doses

Severe Insomnia: PO 5-10 mg NOCTE (Take 30-60 mins before bed). Elderly / Frail: Avoid entirely. If forced, max 2.5 - 5 mg. (Temazepam is vastly superior).

Best Uses

Nitrazepam is a long-acting benzodiazepine hypnotic, but accumulates in elderly causing excessive daytime sedation and falls, and has been largely replaced by shorter-acting agents.

Key Risks

Key Interactions

Opioids, Alcohol (Fatal respiratory arrest). CYP3A4 inhibitors (Clarithromycin, Azoles) prolong half-life further.

Monitoring

Advise the patient strictly not to drive the morning after taking Nitrazepam. Their reaction times will be identical to a drunk driver.

Clinical Pearl

Access

Authority requiredMogadon, Alodorm5 mg tablet

Brand: Mogadon, Alodorm
PBS status: Authority required
Formulation: Tablets (5 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.