Flunitrazepam

When ATH:
N05CD03

Characteristic.

Hypnotic from the group of benzodiazepines.

Pharmacological action.
Snotvornoe.

Application.

Sleep disorders of various origins, premedication, introduction to general anesthesia, maintenance of anesthesia.

Contraindications.

Hypersensitivity, giperkapniя, severe respiratory distress, sleep apnea syndrome, Severe renal and / or hepatic insufficiency, myasthenia, acute ethanol poisoning, hypnotics, painkillers, antipsychotic or antidepressant agents, pour; addiction, alcoholism history, pregnancy (especially I trimester), lactation, natural infancy (including newborns).

Pregnancy and breast-feeding.

Contraindicated in pregnancy (especially in the I trimester). If necessary, use the last trimester of pregnancy or during the first stage of labor should be taken into account, that infants may develop hypotension, hypothermia and respiratory depression. At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: headache, dizziness, fatigue, weakness, impaired concentration, confusion, slowing physical and mental reactions, muscular weakness, paresthesia, anterogradnaya amnesia (It may be accompanied by strange behavior), disorientation upon awakening, paradoxical reactions (alarm, hallucinations, excitation, irritability, aggressiveness, delirium, fits of rage, nightmares, psychosis), sleep disturbance, daytime sleepiness, a manifestation of latent depression, fatigue, ataxia, diplopia, seizures, aftereffect phenomenon.

Other: leukopenia, agranulocytosis, difficulty breathing, gipotenziya, dyspepsia, skin rash, angioedema, urinary retention, changes in libido.

There may be addictive, drug dependence, withdrawal and "return" (see. "Safety Precautions").

Cooperation.

It enhances the effect of antipsychotics deprimiruyuschee, other hypnotic drugs, anxiolytics, Antidepressants, narcotic analgesics, anticonvulsants, anesthetics, Some antihistamines. Ethanol, inhibitors of microsomal oxidation increase the effects (incl. side). When concomitantly with narcotic analgesics may increase euphoria and psychological dependence.

Overdose.

Symptoms: drowsiness, confusion, slackness, ataxia, hypomyotonia, hypotension, respiratory depression, coma, possible death.

Treatment: induction of vomiting, gastric lavage, administration of activated charcoal, airway, monitoring of vital functions, the introduction of a specific benzodiazepine receptor antagonist flumazenil (in hospital).

Dosing and Administration.

Inside, adults-1-2 mg for 20 minutes before sleep, patients older is 0.5-2 mg, children and adolescents 0.5-1.5 mg. The course of treatment from 2-5 days to 2-3 weeks (no more 4 Sun, including the phasing out period).

Parenteral, the dose of 0.015-0.03 mg/kg for then for 30-60 min before the beginning of narcosis/m, for the introduction of anaesthesia-/slow speeds 2 mg / min.

Precautions.

Treatment of insomnia start with the lowest recommended dose and continue as short as possible.

During and after the use of flunitrazepam should be careful when driving, and when performing work, require high concentration and fine motor coordination.

It should be taken into account, that after treatment for several weeks may decrease its effectiveness. The risk of drug dependence increases with dose and duration of treatment, and in patients, having a history information about alcohol or drug abuse. With the development of physical dependence is accompanied by a sudden withdrawal of the drug withdrawal symptoms (headache and muscle pain, alarm, voltage, anxiety, confusion, irritability, depersonalization, hyperacusis, numbness and tingling in the extremities, sensitivity to light, Noise, physical contact, hallucinations, seizures). After discontinuation of the drug may develop the syndrome of return, characterized by a temporary increase in symptoms, which resulted in the appointment of the drug (insomnia, mood changes, alarm, anxiety). On the possibility of a temporary strengthening of symptoms after discontinuation of the drug should notify the patient. The development of paradoxical reactions require discontinuation of the drug. When planning a pregnancy or suspicion of its presence should consult with your doctor about stopping the drug.