Risk factors and safety

What this page is

Confirmed in animal data

• Respiratory depression at higher doses, particularly with oral administration. Naloxone-reversible.
• Dependence with chronic dosing. Withdrawal syndrome on discontinuation.
• Tolerance in some pain assays (notably tail flick) but not others.
• Reinforcing properties in self-administration paradigms, though weaker than heroin.

Plausible based on mechanism but not confirmed in humans

• Drug-drug interactions with other CNS depressants — benzodiazepines, alcohol, gabapentinoids, GHB, other opioids. Synergistic respiratory depression is the central concern.
• Adulteration / misidentification. Material sold as SR-17018 in unregulated markets may contain other compounds, including significantly more dangerous ones such as nitazenes or fentanyl analogs.

Unknown

• Long-term toxicity (hepatic, renal, cardiac, neurological)
• Reproductive and developmental toxicity
• Drug-drug interactions with specific medications, including QT-prolonging drugs, CYP450 substrates, MAOIs
• Abuse potential in vulnerable populations
• Safety in patients with comorbid psychiatric, hepatic, renal, or pulmonary disease

Overdose response

1. Call emergency services.
2. Administer naloxone (Narcan). Repeat doses may be needed because SR-17018's duration may exceed naloxone's.
3. Provide rescue breathing if trained.
4. Place the person in the recovery position.
5. Stay with the person until emergency responders arrive.

Naloxone is available without prescription in all 50 U.S. states and in many other countries.

Getting help

If you are outside the United States, search for your country's national alcohol and other drug helpline. If immediate medical risk is present, call your local emergency number rather than a helpline.