(British Approved Name, US Adopted Name, rINN)
INNs in other languages (French, Latin, Spanish):
Note. The following terms have been used as ‘street names’ or slang names for various forms of flunitrazepam: Circles; Forget me drug; Forget pill; Forget-me pill; Getting roached; La Rocha; Lunch money drug; Mexican valium; Pingus; R2; R-2; Reynolds; Rib; Roach-2; Roaches; Roachies; Roapies; Robutal; Rochas dos; Roche; Roches; Rolpes; Roofies; Rope; Rophies; Rophy; Ropies; Roples; Ropples; Row-shay; Ruffies; Ruffles; Sedexes; Wolfies.
Pharmacopoeias. In Europe and Japan.
European Pharmacopoeia, 6th ed. (Flunitrazepam). A white or yellowish crystalline powder. Practically insoluble in water slightly soluble in alcohol soluble in acetone. Protect from light.
Dependence and Withdrawal
As for Diazepam.
Adverse Effects, Treatment, and Precautions
As for Diazepam.
Abuse. A WHO review concluded that flunitrazepam had a moderate abuse potential that might be higher than that of other benzodiazepines. It was reported that there was current evidence of widespread abuse of flunitrazepam among drug abusers, particularly among those who used opioids or cocaine. Flunitrazepam is tasteless and odourless and has been misused to incapacitate the victim and produce amnesia in sexual assaults and drug-facilitated rape (‘date rape’). A 1-mg dose may produce impairment for 8 to 12 hours. Some manufacturers have incorporated a blue dye into flunitrazepam tablets to increase visibility when placed into drinks but caution is still necessary as it has been reported that blue tropical drinks and punches are being used to overcome this.
Breast feeding. Concentrations in breast milk the morning after a single evening 2-mg dose of flunitrazepam were considered to be too low to produce clinical effects in breast-fed infants, although accumulation in the milk might occur after repeated use.
Local reactions. Of 43 patients given a single intravenous dose of flunitrazepam 1 to 2 mg, two had local thrombosis 7 to 10 days later. The incidence was lower than in those given diazepam [in solution]. However, there was little difference in the incidence of local reactions after intravenous use of flunitrazepam and diazepam in another study.
Porphyria. Flunitrazepam has been associated with acute attacks of porphyria and is considered unsafe in porphyric patients.
As for Diazepam.
Flunitrazepam is readily absorbed from the gastrointestinal tract. About 77 to 80% is bound to plasma proteins. It is extensively metabolised in the liver and excreted mainly in the urine as metabolites (free or conjugated). Its principal metabolites are 7-aminoflunitrazepam and N-desmethylflunitrazepam N-desmethylflunitrazepam is reported to be pharmacologically active. The elimination half-life of flunitrazepam is reported to be between 16 and 35 hours. Fluni-trazepam crosses the placental barrier and is distributed into breast milk.
Pregnancy. Concentrations of flunitrazepam in umbilicalvein and umbilicalartery plasma were lower than those in maternal venous plasma about 11 to 15 hours after a dose of flunitrazepam 1 mg in 14 pregnant women concentrations in amniotic fluid were lower still.
Uses and Administration
Flunitrazepam is a short-acting benzodiazepine with general properties similar to those of diazepam. It is used in the short-term management of insomnia, as a premedicant in surgical procedures, and for induction of anaesthesia.
A usual oral dose for insomnia is 0.5 to 1 mg at night up to 2 mg may be given if necessary. In elderly or debilitated patients the initial dose should not exceed 0.5 mg at night, up to 1 mg may be given if necessary.
A dose of 1 to 2 mg (15 to 30 micrograms/kg) has been given intramuscularly or orally for premedication or by slow intravenous injection for induction of general anaesthesia.
Argentina: Nervocuril Parsimonil Primum Rohypnol
Austria: Guttanotte Rohypnol Somnubene
Brazil: Rohydorm Rohypnol
Chile: Ipnopen Rohypnol
Czech Republic: Rohypnol
Denmark: Flunipam Rohypnol Ronal
France: Narcozep Rohypnol
Germany: Flunif Flunibeta Flunimerck Fluninoc Rohypnol
Greece: Hipnosedon llman Neo Nifalium Nilium Vulbegal
Hong Kong: Absintf Flunita Rohypnol
Italy: Darkene Roipnol Valsera
The Netherlands: Rohypnol
Norway: Flunipam Rohypnol
Portugal: Rohypnol Sedex
South Africa: Hypnor Insom Rohypnol
Sweden: Fluscand Rohypnol
United Kingdom: Rohypnol