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Isotonitazene is a benzimidazole derived opioid analgesic drug related to etonitazene, which has been sold as a designer drug. It has only around half the potency of etonitazene in animal studies,but this still makes it a similar strength to fentanyl and its analogues, and consequently isotonitazene can be expected to pose a significant risk of producing life-threatening respiratory depression, as well as other typical opioid side effects such as sedation, itching, nausea and vomiting.
Isotonitazene (obtained from an online vendor) was fully characterized in November 2019 in a paper where the authors did a full analytical structure elucidation in addition to determination of the potency at the μ-opioid receptor using a biological functional assay in vitro. While isotonitazene was not compared directly to morphine in this assay, it was found to be around 2.5x more potent than hydromorphone and slightly more potent than fentanyl.
Side effects of benzimidazole derived opioids are expected to be similar to those of fentanyl, which include itching, nausea and potentially serious respiratory depression, which can be life-threatening. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear. Isotonitazene has been detected in multiple fatalities in the US since August 2019.
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