nitrazepam.txt

CLINICAL USE

Benzodiazepine:Hypnotic

DOSE IN NORMAL RENAL FUNCTION

5–10 mg at bedtime; elderly (or debilitated) 2.5–5 mg

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :281.3

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :87

%Excreted unchanged in urine &nbsp &nbsp : <5

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :2

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :24–30/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function. Start with small doses

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antibacterials: metabolism possibly increased by rifampicin

Antipsychotics: increased sedative effects

Antivirals: concentration possibly increased by ritonavirDisulfiram: metabolism of nitrazepam inhibited, increased sedative effectsSodium oxybate: enhanced effects of sodium oxybate – avoid

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Mild to moderate renal insufficiency does not alter the kinetics of nitrazepamCKD 5 patients will be more susceptible to adverse effects (drowsiness, sedation, unsteadiness).

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