Flunitrazepam

May be taken with or without food.

Preexisting CNS depression or coma, resp depression, acute pulmonary insufficiency or sleep apnoea; severe hepatic impairment; chronic psychosis, phobic or obsessional states; may precipitate suicide or aggressive behavior; not to be used alone to treat depression or anxiety associated with depression; glaucoma. Pregnancy, lactation. Neonates.

Chronic pulmonary insufficiency; elderly or debilitated patients; muscle weakness, impaired liver or kidney function; drowsiness may affect skilled tasks; monitor cardio-respiratory function when used for deep sedation; personality disorders or organic brain changes; history of alcohol or drug addiction. resp depression and hypotension with parenteral admin; this route should only be used when facilities for reversing resp depression are available.

Drowsiness and lightheadedness, sedation, muscle weakness and ataxia; less frequently vertigo, headache, confusion, depression, slurred speech, changes in libido, tremor, visual disturbances, urinary retention, GI disturbances, changes in salivation and amnesia.

Enhanced sedation or resp and CV depression with drugs with CNS depressant properties eg, antidepressants, antihistamines, antipsychotics, general anaesthetics, other hypnotics or sedatives, opioid analgesics and cisapride. Alcohol. Calcium-channel blockers; clonidine; diaxozide; disulfiram; clozapine; diuretics; moxonidine; nabitone; nitrates; cimetidine, esomeprazole and omeprazole; muscle relaxants; dopaminergics; lofexidine; hydralazine, minoxidil and nitroprusside; antifungals; angiotensin II receptor antagonist; antiepileptics; β-blockers; antibacterials.
Potentially Fatal: Drugs which alter the hepatic microsomal enzymes.

Description:
Mechanism of Action: Flunitrazepam is a short-acting benzodiazepine with general properties similar to diazepam.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract.
Distribution: About 77-80% is bound to plasma proteins.
Metabolism: Extensively metabolised hepatically.
Excretion: Mainly in the urine as metabolites. Elimination half-life: 16-35 hr.

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