Summary
Withdrawn from Dutch market in 2004 following pediatric fatality. Extremely delayed onset encourages dangerous redosing before peak effects manifest. Historical 5 mg tablets represented supratherapeutic doses for opioid-naive users. Prodrug rapidly hydrolyzed to active metabolite despropionyl-bezitramide (R-4618) in gastrointestinal tract.
Dose Information
Light
Common
Strong
Heavy
Onset, Duration & After-effects
| ROA | Onset | Peak | Offset | After Effects |
|---|---|---|---|---|
| Oral | 1-3 hrs | 2.5-5 hrs | 8-12 hrs | 6-12 hrs |
Tolerance
Build-up
develops within days of regular use; analgesic tolerance faster than respiratory depression tolerance
Reset
7–14 days for partial reset; full reset may take weeks — tolerance loss greatly increases overdose risk
Effects
Positive
- Pain relief
- Physical euphoria
- Cough suppression
- Stimulation
Negative
- Respiratory depression
- Nausea
- Tachycardia
- Sedation
- Itchiness
- Difficulty urinating
Positive
- Cognitive euphoria
- Anxiety suppression
- Reduced anxiety
- Wakefulness
- Motivation enhancement
- Euphoria
- Alertness enhancement
Negative
- Constipation
- Anxiety
- Talkativeness
Positive
- Warmth
- Increased music appreciation
- Increased libido
Negative
- Appetite suppression
- Light sensitivity
- Disinhibition
- Dehydration
- Dulled perception
- Internal hallucination
- Warm flush