Meds and you

Updated 11 February 2013

Flunitrazepam

Flunitrazepam is a powerful hypnotic medication prescribed for the short-term treatment of Insomnia.

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Flunitrazepam is the active ingredient of Sandoz Flunitrazepam, Hypnor and Rohypnol.

General Information

Flunitrazepam is a powerful hypnotic medication prescribed for the short-term treatment of Insomnia.

Flunitrazepam is commonly used as a date rape drug (street slang refer to it as a roofie).

This benzodiazepine should in most case not be used for longer than 2-4 weeks, as tolerance and physical and psychological dependence can occur. flunitrazepam shares with other benzodiazepines the risk of abuse, misuse, psychological and/or physical dependence.

If prescribed for longer than 4 weeks your prescriber should periodically reassess the need for flunitrazepam.

How does flunitrazepam work?

Flunitrazepam has an effect on gamma-aminobutyric acid (GABA). GABA is the brain's quieting or tranquilising neurotransmitter, possessing an inhibitive effect on the transmission of nerve signals. Flunitrazepam and other benzodiazepines enhance the effect of GABA, thus slowing down the transmission of nerve signals.

Fast facts

Drug schedule: Schedule 5

Available as: Flunitrazepam is available as tablets.

What does it do? Flunitrazepam has an anti-insomnia action.

Overdose risk: High

Dependence risk: High

Is flunitrazepam available as a generic? Yes

Is flunitrazepam available on prescription only? Yes

User information

Onset of effect: Within 1 hour

Duration of action: Up to 12 hours

Dietary advice: Flunitrazepam may be taken with or without food.

Stopping this medicine: Flunitrazepam should not be stopped abruptly. Sudden discontinuation may lead to withdrawal symptoms. The dosage of flunitrazepam should be gradually reduced according to the advice of your doctor.

Prolonged use: Short-term therapy is advised, treatment should generally be no longer than 4-6 weeks, including a tapering off process. Tolerance has been noted with long term use. Do not take flunitrazepam for longer periods unless strictly instructed by your doctor.

Special precautions

Never exceed the prescribed dose of flunitrazepam.

Consult your doctor before using this drug if:

  • You have a known hypersensitivity to benzodiazepines
  • You have acute closed-angle glaucoma
  • You have myasthenia gravis
  • You have liver or kidney disease
  • You have a history of alcohol or substance abuse
  • You have a chronic lung disease
  • You suffer from epilepsy
  • You have a mental illness or suffer from depression
  • You suffer from sleep apnoea.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: Use with caution as side effects may be emphasised. Dosage may need adjustment

Driving and hazardous work: This medication should be avoided as it may cause extreme sedation

Alcohol: Flunitrazepam's effect may intensify the effect of alcohol and vice versa. Do not consume alcohol while taking this medication, as side effects may be drastically pronounced.

Possible side effects:

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Extreme Drowsiness

x

x

Loss of coordination/dizziness

X

x

Slurred speech

X

x

Change in libido

X

x

Fever/chills

X

x

Extreme fatigue

X

x

Nausea/vomiting

X

x

Rash/itching

X

x

Anger/behaviour changes

X

x

Impaired memory

X

x

Interactions:

Drug interactions:

Alcohol, antihistamines, antidepressants, other benzodiazepines, narcotics

Increased depression of central nervous system (CNS)

Digoxin

Increased possibility of digoxin toxicity

Disulfiram

Increased possibility of flunitrazepam toxicity

Ketokonazole and other related antifungals

Increased possibility of flunitrazepam toxicity

Cimetidine

Increased possibility of flunitrazepam toxicity

Isoniazid

Increased possibility of flunitrazepam toxicity

Oral contraceptive

Increased possibility of flunitrazepam toxicity

Propranolol

Increased possibility of flunitrazepam toxicity

Valproic acid

Increased possibility of flunitrazepam toxicity

Isoniazid

Increased possibility of flunitrazepam toxicity

Levodopa

Decreases levodopa's anti-Parkinson effect.

Probenecid

Increased possibility of lunitrazepam toxicity

Rifampicin

May decrease the effect of flunitrazepam.

Theophylline

May counteract the sedative effects of flunitrazepam.

Disease interactions

Consult your doctor before using this drug if you have acute closed-angle glaucoma, myasthenia gravis, liver or kidney disease, a chronic lung disease or epilepsy; also if you suffer from mental illness or depression or sleep apnoea.

Overdose action

An overdose of flunitrazepam can be serious. Seek immediate emergency medical attention. Symptoms may include poor coordination, slow breathing, tremors, drowsiness, slurred speech, confusion, slow reflexes and loss of consciousness.

Recommended dosage

0.5-1 mg/day, strictly as prescribed by your doctor

 

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