The supplier of nitrazepam (Nitrados) tablets has informed PHARMAC it will no longer be able to supply nitrazepam tablets in New Zealand.
This means nitrazepam will no longer be funded once the current supply runs out as no other brands of this medication are available.
People taking nitrazepam will need to talk to their health care professional about alternative treatments.
Prescribers will need to:
- ensure no new patients are started on nitrazepam
- review all existing patients and where appropriate for intermittent users of nitrazepam make a plan to gradually withdraw nitrazepam and provide supportive sleep hygiene advice
- identify patients who use nitrazepam long term and start transitioning them on to an alternative, such as diazepam.
When will this happen?
- 1 August 2019 – Nitrazepam will no longer be funded for new patients. People currently on nitrazepam will continue to have access to treatment.
- June 2020 – stocks of nitrazepam will run out at which point it will be delisted from the Pharmaceutical Schedule. All patients will need to be transitioned before this time.
What are the funded treatment options?
The clinical advice we have received from the Mental Health Subcommittee of the Pharmacology and Therapeutics Advisory Committee (one of our expert clinical advisory committees) is that for patients who use nitrazepam chronically, prescribers should consider transitioning them onto diazepam as it has a long half-life, so is less likely to cause withdrawal symptoms. Then on a case-by-case basis, consider these patients for a very slow withdrawal but only where this is clinically appropriate.
Information for prescribers about changing patients
Bpacnz has published an article discussing the use of benzodiazepines in New Zealand https://bpac.org.nz/BPJ/2015/February/benzodiazepines.aspx(external link).
Bpacnz has also published an article on hypnotics used for managing insomnia which may be useful https://bpac.org.nz/2017/insomnia-1.aspx(external link) .
Where can I get more information?
If you have any questions, please contact PHARMAC at 0800 66 00 50 or firstname.lastname@example.org.
Last updated: 18 June 2019