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Flunitrazepam

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flunitrazepam
Type benzodiazepine
Group benzodiazepine
links
ATC-code N05CD03
CAS-number 1622-62-4
PubChem 3380
PubMed flunitrazepam
Kompas (nl) flunitrazepam
Wikipedia flunitrazepam
more info
DDD 2mg [1]
Ctox 50μg/L [2] [3]
EQ-dosage 10[4] diazepam
T1/2 25.5h [1]
Teff 118h [5]
metabolites 3[1]
bioavailability 80%[1]
administration oral
tablets 1,2 mg [6]
Price/day 0 [7]

flunitrazepam is a benzodiazepine in the group benzodiazepine.


Caution area Value Ref Description
Lactation 8 [1] Unsafe and possibly harming
Pregnancy 6 [1] high risk - C - suspected to cause reversible damage, but no malfunctions
Diabetes mellitus 2 [8] very weak influence on diabetes - probably safe, consider monitoring
Hepatic insufficiency 8 [1] Unsafe with mild hepatic impairment (Child-Pugh classification A - monitoring required)
Children 8 [9][10] inapplicable - not registered, poorly studied
Elderly 8 [6][11] unsafe - adapt dosage or substitute drug
Dementia 8 [4] strong influence on cognition
Chronic Obstructive Pulmonary Disease 6 [12][13] average safety - consider dose-adaptation
Hypertension 10 [18] very common (over 1 in 10 patients: > 10%)
Hypotension 6 [4] uncommon (between 1 in 100 and 1 in 1,000 patients: 0,1% - 1%)
Heart failure 2 [8] weak influence on HF - rather safe, monitoring recommended
Long QT-syndrome 1 [14] no prolongation of QTc-interval - safe - Arizona Scale - not listed
Seizures 1 safe - occurrence extremely rare (case-report)
Cerebrovascular accidents 2 [8] weak influence on CVA - safe, monitoring recommended
Renal insufficiency 2 [1] generally safe - unsafe when MDRD < 10 (end stage renal disease (ESRD))
Dyskinesia 1 [15] occurrence extremely rare (case-report)
Movement disorders 1 [19][20] safe - occurrence extremely rare (case-report)
Haematology 1 occurrence extremely rare (case-report)
Anticholinergic effects 6 [6] uncommon (between 1 in 100 and 1 in 1,000 patients: 0,1% - 1%)
Male sexual dysfunction 6 [6] uncommon (between 1 in 100 and 1 in 1,000 patients: 0,1% - 1%)
Female sexual dysfunction 6 [6] uncommon (between 1 in 100 and 1 in 1,000 patients: 0,1% - 1%)
Traffic 10 [1][16][17] severe influence (category III) >0,8 g/l (>0,8‰)
Weight 6 [6] uncommon (between 1 in 100 and 1 in 1,000 patients: 0,1% - 1%)
Weight gain 0 unknown/unverified
Weight loss 0 unknown/unverified
Photosensitivity 0 unknown/unverified
Sedation 10 [18] very common (over 1 in 10 patients: > 10%)
Poor CYP2D6 metabolizer 0 unknown/unverified
Ultra rapid CYP2D6 metabolizer 0 unknown/unverified
Poor CYPC19 metabolizer 0 unknown/unverified
Ultra rapid CYP2C19 metabolizer 0 unknown/unverified


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 KNMP; Informatorium Medicamentorum 2009; Monografie "flunitrazepam" (Dutch)
  2. NVZA; Toxicology.org; Monografie ID=29 (dutch)
  3. MICROMEDEX; POISINDEX Benzodiazepines; Section 7.5.2 Toxic Concentrations
  4. 4.0 4.1 4.2 KNMP; Informatorium Medicamentorum 2009; Inleidende tekst "Benzodiazepineagonisten" (Dutch)
  5. Ashton, H. BENZODIAZEPINE EQUIVALENCY TABLE. April 2007
  6. 6.0 6.1 6.2 6.3 6.4 6.5 CVZ; Farmacotherapeutisch Kompas - flunitrazepam (dutch)
  7. oraal 1.09/maand/DDD cf FTK: results in €0.04
  8. 8.0 8.1 8.2 Bazire S. Psychotropic drug directory 2007. Trowbridge: Cromwell Press; 2007
  9. Konishi T, Masuko K, Naganuma Y, Hongou K, Yagi S. Flunitrazepam for sleep disturbance in children with intractable epilepsy. Brain Dev. 1995 Jan-Feb;17(1):69-72  (pubmed-id 7762768)
  10. Forster A, Gamulin Z, Morel D, Weiss V, Rouge JC. Respiratory depression following orally administered flunitrazepam for preanesthetic medication in children. Anesthesiology. 1984 Nov;61(5):597-601  (pubmed-id 6497000)
  11. Seppälä M, Alihanka J, Himberg JJ, Kanto J, Rajala T, Sourander L. Midazolam and flunitrazepam: pharmacokinetics and effects on night time respiration and body movements in the elderly. Int J Clin Pharmacol Ther Toxicol. 1993 Apr;31(4):170-6  (pubmed-id 8500918)
  12. Murciano D, Aubier M, Palacios S, Pariente R. Comparison of zolpidem (Z), triazolam (T), and flunitrazepam (F) effects on arterial blood gases and control of breathing in patients with severe chronic obstructive pulmonary disease (COPD). Chest. 1990 Mar;97(3 Suppl):51S-52S  (pubmed-id 2307006)
  13. Midgren B, Hansson L, Skeidsvoll H, Elmqvist D. The effects of nitrazepam and flunitrazepam on oxygen desaturation during sleep in patients with stable hypoxemic nonhypercapnic COPD. Chest. 1989 Apr;95(4):765-8  (pubmed-id 2924606)
  14. Taylor D, Paton C, Kapur S. The Maudsley prescribing guidelines, 10th edition. London: Informa Healthcare; 2009
  15. Bhoopathi PS, Soares-Weiser K. Benzodiazepines for neuroleptic-induced tardive dyskinesia. Cochrane Database Syst Rev. 2006 Jul 19;3:CD000205  (pubmed-id 16855954)
  16. The International Council on Alcohol, Drugs and Traffic Safety (ICADTS). ICADTS drug list - July 2007 (Internet)
  17. Bramness JG, Skurtveit S, Mørland J. Flunitrazepam: psychomotor impairment, agitation and paradoxical reactions. Forensic Sci Int. 2006 Jun 2;159(2-3):83-91  (pubmed-id 16087304)
  18. 18.0 18.1 Kanto J, Kangas L, Leppänen T. A comparative study of the clinical effects of oral flunitrazepam, medazepam, and placebo. Int J Clin Pharmacol Ther Toxicol. 1982 Sep;20(9):431-3  (pubmed-id 6128313)
  19. Smales OR, Smales EA, Sanders HG. Flunitrazepam in terminal care. J Paediatr Child Health. 1993 Feb;29(1):68-9  (pubmed-id 8461186)
  20. Marino Júnior R, Benabou R, Benabou S. Therapeutic effects of flunitrazepam in dystonias and torticollis. Preliminary communication. Arq Neuropsiquiatr. 1993 Jun;51(2):285-6  (pubmed-id 8274097)