A benzodiazepine sleeping tablet
Nitrazepam
A long-acting benzodiazepine sleeping tablet for short-term, severe insomnia; it can cause next-day drowsiness and dependence, so it is used only briefly.
What is Nitrazepam?
Nitrazepam is a benzodiazepine sleeping tablet used in the UK for short-term treatment of severe insomnia. It helps you fall asleep by calming activity in the brain, but it is long-acting, so it can leave you feeling drowsy or hungover the next day. Because it can cause dependence, it is meant for short-term use only and is used with particular care in older people because of the risk of falls.
Education and reference only. This is a plain-language guide to Nitrazepam — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Nitrazepam is a long-acting benzodiazepine used as a sleeping tablet for short-term treatment of severe insomnia that is causing distress. It works on the brain's calming chemical messenger system to help you fall asleep more quickly and stay asleep. Because it is long-acting, its effects can carry over into the next day, and because the body becomes used to it, it is intended for short-term use only rather than as an ongoing solution for poor sleep.
How it works
Nitrazepam enhances the action of GABA, the brain's main calming chemical messenger. By making GABA more effective it reduces over-activity in the brain, producing drowsiness and helping sleep. Because it stays in the body for a relatively long time, this sedating effect can persist into the following day, which is why next-day drowsiness is common.
Company & origin
Originated / developed by: Developed by Roche..
Nitrazepam is a benzodiazepine introduced by Roche in the 1960s and used in the UK as a sleeping tablet for short-term, severe insomnia.
What it treats
Conditions Nitrazepam is used for
Practical use
How to take Nitrazepam
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it at bedtime, only when you can allow a full night's sleep, as it is long-acting.
- Use it for the shortest time possible — it is intended for short-term use, not every night long-term.
- Be aware you may feel drowsy or hungover the next morning; avoid driving until you are sure you are not affected.
- Do not drink alcohol with it, as this adds to the drowsiness and slowed breathing.
- If you have taken it regularly, do not stop suddenly — ask your prescriber, who will reduce it gradually.
Weighing it up
Advantages & disadvantages of Nitrazepam
Advantages
- It can provide effective short-term relief when severe insomnia is causing real distress.
- It helps you fall asleep more quickly and stay asleep during a difficult period.
- A short, time-limited course can break a cycle of poor sleep while other approaches are put in place.
Disadvantages
- Being long-acting, it often causes next-day drowsiness and a hungover feeling.
- The body quickly becomes used to it and it can cause dependence, so it is only for short-term use.
- It increases the risk of falls and confusion, especially in older people.
Practical use
Good to know
Nitrazepam is taken at bedtime and is meant for short-term use only — typically a short course rather than every night long-term, because the body quickly becomes used to it and it can cause dependence. As it is long-acting, many people feel drowsy, slowed or hungover the next morning, which can affect driving and concentration. In older people it raises the risk of falls and confusion, so it is used with particular caution. Alcohol adds to the drowsiness and should be avoided, and it should not be stopped abruptly after regular use.
Who should not take it / use with caution
- People with severe breathing problems or sleep apnoea.
- People who misuse alcohol or other sedating drugs, unless specialist-managed.
- Older or frail people, in whom it is used with great caution because of falls, confusion and daytime drowsiness.
Monitoring
- Review of whether the sleeping tablet is still needed, aiming to keep the course short.
- Watching for daytime drowsiness, unsteadiness and falls, especially in older people.
- Gradual reduction rather than abrupt stopping after regular use.
Side effects
- Next-day drowsiness, a hungover feeling, and slowed reactions.
- Dizziness, unsteadiness and an increased risk of falls.
- Confusion or memory problems, particularly in older people.
- With regular use, tolerance and dependence; rebound insomnia can occur when stopping.
Key interactions
- Other sedating medicines such as opioid painkillers, other sleeping tablets, gabapentin or pregabalin increase drowsiness and breathing risk.
- Alcohol adds to the sedation and should be avoided.
- Some medicines that affect liver enzymes can alter nitrazepam levels.
Available as: Tablets and an oral suspension.
Answers
Nitrazepam: frequently asked questions
Why does nitrazepam make me feel hungover the next day?
Nitrazepam is long-acting, so it stays in the body for a relatively long time. This means its sedating effect can carry over into the next morning, leaving you feeling drowsy, slowed or hungover. Take care with driving until you know how it affects you.
Can I take nitrazepam every night?
No — it is meant for short-term use only. The body quickly becomes used to it, it can stop working as well, and it can cause dependence. Your prescriber will usually keep the course short and review it.
Is nitrazepam safe for older people?
It is used with particular caution in older people because it increases the risk of falls, confusion and daytime drowsiness. Other approaches to sleep are usually preferred where possible.
Can I stop nitrazepam suddenly?
If you have taken it for only a short time this is less of an issue, but after regular use it is better to reduce it gradually. Stopping suddenly can cause rebound insomnia and withdrawal, so ask your prescriber for advice.
Can I drink alcohol with nitrazepam?
No — alcohol adds to the drowsiness and slowed reactions and can increase the risk of dangerously slowed breathing. It should be avoided.
The wider class
About Benzodiazepines & Z-drugs
Nitrazepam belongs to the benzodiazepines & z-drugs class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
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