Rohypnol
Rohypnol: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Rohypnol
ATX code: N05CD03
Active ingredient: flunitrazepam (Flunitrazepam)
Manufacturer: F. Hoffmann-La Roche Ltd. (F. Hoffmann-La Roche Ltd.) (Switzerland); Lechiva (Czech Republic)
Description and photo update: 03.10.2019
Rohypnol is a drug with anxiolytic, sedative, anticonvulsant, hypnotic, muscle relaxant effect.
Release form and composition
Dosage forms of release:
- coated tablets (10 pcs. in blisters, 1-3 blisters in a cardboard box);
- tablets (10 pcs. in blisters, 2 blisters in a cardboard box);
- solution for injection (1 ml in ampoules, 5 ampoules in a cardboard box, complete with solvent (5 pcs.)).
Each pack also contains instructions for the use of Rohypnol.
Active ingredient in 1 tablet: flunitrazepam - 1 mg.
The active substance is in the composition of 1 ml of injection solution: flunitrazepam - 2 mg.
Pharmacological properties
Pharmacodynamics
Flunitrazepam, which is part of Rohypnol as an active ingredient, has a pronounced hypnotic effect. The effect is due to an increase in the inhibitory effect of gamma-aminobutyric acid (GABA) in the central nervous system by stimulating benzodiazepine receptors and increasing the sensitivity of GABA receptors to the mediator. The substance reduces the excitability of the subcortical structures in the brain, inhibits polysynaptic spinal reflexes.
The hypnotic effect of flunitrazepam develops rapidly, lasts from 6 to 8 hours. The drug also has a sedative, anxiolytic, central muscle relaxant and anticonvulsant effect. Inhibits psychomotor activity, reduces emotional stress, reduces anxiety, anxiety, fear, and causes amnesia.
Pharmacokinetics
After oral administration of 1 mg of flunitrazepam, its maximum concentration (Cmax) in plasma is 6-11 ng / ml and is observed after 0.75-2 hours. The bioavailability of the substance is 70-90%. When taken simultaneously with food, the rate and extent of absorption decreases. Up to 78% binds to blood proteins. With daily intake, there is a moderate accumulation of the substance in the plasma. Due to repeated administration, the equilibrium plasma concentration of flunitrazepam is achieved after 5 days and for a dose of 2 mg / day is at least 3-4 ng / ml.
Total plasma clearance is 120–140 ml / min. In the equilibrium state, the volume of distribution is 3–5 l / kg. Flunitrazepam penetrates the cerebrospinal fluid quickly. It passes through the placental barrier slowly, excreted in breast milk during lactation.
The substance is metabolized in the liver, including 10-15% through the first passage (presystemic elimination). The main metabolites formed in plasma are N-desmethylflunitrazepam and 7-aminoflunitrazepam, in urine - 7-aminoflunitrazepam. The equilibrium concentration index of the pharmacologically active N-demethyl metabolite is practically identical to that of the parent substance.
The drug is excreted mainly in the urine, mainly in the form of metabolites, and with feces. The half-life of flunitrazepam is from 16 to 35 hours, N-demethylflunitrazepam is 28 hours.
Indications for use
- insomnia (especially when it is difficult to fall asleep), superficial shallow sleep;
- premedication before anesthesia, induction anesthesia (for injection solution).
Contraindications
An absolute contraindication for the use of any form of the drug is myasthenia gravis, including myasthenia gravis.
Relative indications for which Rohypnol is prescribed with caution, due to the increased likelihood of complications:
- severe chronic hypercapnia;
- respiratory failure;
- severe functional disorders of the kidneys / liver;
- pregnancy (especially the first trimester) and lactation;
- age up to 15 years;
- hypersensitivity to the components of the drug.
Rohypnol, instructions for use: method and dosage
The dose of Rohypnol is set individually.
Recommended dosage regimen:
- tablets: ½-1 pc. (for prolonged sleep disorders - 1-2 pcs.); the drug is recommended to be taken immediately before bedtime (preferably not immediately after a meal);
- injection solution: adults - 1-2 mg, children - 0.015-0.03 mg / kg; the drug is administered immediately after mixing the contents of the ampoules; method of administration: premedication - intramuscularly, induction anesthesia - intravenously.
Side effects
Possible side reactions: headaches, disorientation upon awakening, respiratory depression, temporary anterograde amnesia, fatigue, myasthenia gravis, slight arterial hypotension (with parenteral administration, especially in elderly patients), dyspepsia, drug dependence (with a long course).
Overdose
Symptoms of flunitrazepam overdose are lethargy, confusion, drowsiness, ataxia, hypotension, muscle hypotension, respiratory depression, coma, and even death.
For the treatment of the condition, it is recommended to induce vomiting, perform gastric lavage, give the patient activated charcoal, ensure airway patency, and monitor vital functions. In a hospital setting, if necessary, it is possible to administer flumazenil (a specific antagonist of benzodiazepine receptors).
special instructions
You should not suddenly interrupt the long-term use of Rohypnol tablets (a gradual dose reduction is shown).
The use of alcoholic beverages during the course of the therapeutic course is not recommended.
Influence on the ability to drive vehicles and complex mechanisms
During treatment, it is necessary to refuse to drive vehicles and work, the performance of which requires quick psychomotor reactions and increased concentration of attention.
Application during pregnancy and lactation
Rohypnol is contraindicated for use during pregnancy and during breastfeeding (lactation).
Pediatric use
In pediatric practice, Rohypnol is not used in the first month of life of newborns, especially premature babies. For the treatment of children and adolescents under 15 years of age, the drug is prescribed exclusively for absolute indications.
With impaired renal function
Patients with impaired renal function should be careful while taking Rohypnol.
For violations of liver function
Patients with impaired hepatic function should be careful while taking Rohypnol.
Use in the elderly
Rohypnol is prescribed with caution to elderly patients.
Drug interactions
When combined with Rohypnol, there is an increase in the effect of drugs that depress the central nervous system, including alcohol.
Analogs
Analogues of Rohypnol are: Flunitrazepam-Ferein, Sedex, Narkozep, Somnubene, Hypnosedon, Primum, Hypnodorm, Flunitrazepam-Teva, Walsera.
Terms and conditions of storage
Store in a dark, dry place out of the reach of children, at a temperature of 10-25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Rohypnol
Since flunitrazepam contributes to the deterioration of cognitive functions, leading to a lack of concentration, confusion and anterograde amnesia, recently in some countries, including Russia, its medical use has been discontinued, replacing it with more effective drugs.
Rohypnol, according to reviews, with high efficiency and strong long-term action, is not a harmless drug, like other benzodiazepines. It is addictive and addictive. Therefore, patients recommend taking it in short courses, no more than two weeks, in the minimum effective dose. It should also be borne in mind that the drug can impair mental performance and cause memory loss.
The price of Rohypnol in pharmacies
The drug is not on sale because the registration period has expired.
The approximate price of Rohypnol in online Internet pharmacies for 1 mg tablets (10 pcs. In a blister, 3 blisters in a package) is 1290-1320 rubles.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
