Nitrazepam has long been associated with extreme hepatic Conditions, just like other nitrobenzodiazepines. Nitrobenzodiazepines including nitrazepam, nimetazepam, flunitrazepam, and clonazepam are more harmful on the liver than other benzodiazepines as they are metabolically activated by CYP3A4 which can result in cytotoxicity.Tolerance to nitrazep