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Hypnotic / Anticonvulsant  ·  Benzodiazepine

Nitrazepam

Also known as: Mogadon, Alodorm, Nitravet

A benzodiazepine hypnotic used for severe short-term insomnia and certain childhood epilepsy syndromes, intended only for the shortest possible duration.

ATC CodeN05CD02
Kenya EML 2023Listed
Level of UseLevel 4-6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Controlled Medicine

Controlled substance. Prescription required from a registered healthcare provider under the Narcotic Drugs and Psychotropic Substances Act.

What it treats

Which conditions is Nitrazepam used for?

Insomnia (short-term, severe)Epilepsy (childhood syndromes)

Overview

What is Nitrazepam?

Nitrazepam is a long-acting benzodiazepine used in two specific contexts: for severe short-term insomnia in adults when other approaches have not worked, and for certain childhood epilepsy syndromes, particularly infantile spasms and Lennox-Gastaut syndrome.

It is listed in Kenya's Essential Medicines List 2023 at Level 4-6. Because it remains in the body for a long time, it can cause significant next-day drowsiness and cognitive impairment.

For sleep difficulties, non-medicine approaches should always be tried before medicines. When a medicine is needed, nitrazepam should be used at the lowest effective dose for the shortest possible time.

How it works

What does it do in the brain?

Nitrazepam acts on GABA-A receptors throughout the brain and nervous system, enhancing the calming effect of GABA. This produces sedation, reduces the time it takes to fall asleep, and reduces night-time waking. In epilepsy, the same mechanism reduces the likelihood of seizures.

Formulations in Kenya

How is it available?

Tablet
5 mg, 10 mg
Taken by mouth at bedtime
Available at Level 4 to 6

Availability across Africa

Where is it available in Africa and what is it called?

Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
CountryCommon Brand Name(s)Notes
South AfricaMogadon, Nitrazepam (generic)Available on prescription in both sectors; mainly used for childhood epilepsy syndromes.
NigeriaMogadonAvailable at select teaching hospitals for childhood epilepsy; controlled substance.
GhanaNitrazepam (generic)Available at Korle-Bu and select specialist pharmacies.
UgandaNitrazepam (generic)Available at Butabika Hospital pharmacy and select private pharmacies in Kampala.

Side effects

What might you feel while taking it?

These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.

  • Next-day drowsiness and impaired alertness
  • Memory impairment
  • Dizziness and poor coordination, increases fall risk
  • Muscle weakness
  • Tolerance, effectiveness reduces with regular use
  • Rebound insomnia when the medicine is stopped
Go to a doctor or emergency room straight away if you notice any of the following.
  • Dependence develops relatively quickly with regular use
  • In elderly patients, the prolonged sedation significantly raises the risk of falls and fractures
  • Breathing difficulty when combined with alcohol or other sedating substances

Who should not take it

Important warnings before starting

Tell your doctor about all your medical conditions, allergies, and other medicines before starting Nitrazepam.
  • Sleep apnoea
  • Severe respiratory insufficiency
  • Myasthenia gravis
  • Severe liver disease

Special care needed

Situations that need extra attention

  • Do not drive or operate machinery the day after taking nitrazepam
  • Do not take with alcohol
  • Elderly patients are particularly vulnerable to falls and cognitive effects
  • Use for the shortest possible time, typically no more than two to four weeks for insomnia
  • Discuss a stopping plan with your doctor from the start of treatment
Pregnancy
Not recommended during pregnancy. Speak to your doctor if you become pregnant while taking this medicine.
Breastfeeding
Passes into breast milk. Not recommended during breastfeeding.

Other medicines

Medicines and substances that can interact with it

Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
  • Alcohol: Significantly amplifies sedation and respiratory depression. Avoid entirely.
  • Opioid pain medicines and other sedating drugs: Combined sedation can become dangerous.

Tests and follow-up

What your doctor will monitor

  • Duration of use reviewed at every appointment
  • Daytime functioning and alertness, particularly in elderly patients
  • Signs of dependence or difficulty reducing the medicine

Stopping this medicine

What happens if you stop taking it?

Do not stop nitrazepam suddenly after regular use. Withdrawal can cause severe rebound insomnia, anxiety, and in some cases seizures. A gradual reduction over several weeks under medical supervision is needed.

In Kenya

What you should know about this medicine in Kenya

Nitrazepam is available in Kenya at Level 4 and above. Given its prolonged action and next-day sedation, it is generally not the first choice for insomnia management.

Sleep problems in Kenya are frequently secondary to anxiety, depression, or difficult life circumstances. Addressing the underlying cause is more effective than long-term use of any hypnotic medicine.

Awareness of its controlled status and dependence potential is important for both prescribers and patients.

Sources

References

  1. Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
  2. Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
  3. World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.