Ro48-6791 was developed as an alternative to the short-acting imidazobenzodiazepine midazolam, for use in induction of anaesthesia and conscious sedation for minor invasive procedures. Ro48-6791 has properties similar to those of midazolam, being water-soluble, with a fast onset and short duration of action. It is 4-6x more potent than midazolam,[2] and slightly shorter acting,[3] and produces similar side effects such as sedation and amnesia.
It was tested up to Phase II human trials, but while it produced less respiratory depression than propofol, it had a longer recovery time and was deemed not to have any significant advantages over the older drug.[4] Similarly when Ro48-6791 was compared to midazolam, it had similar efficacy, higher potency and a shorter recovery time, but produced less of a synergistic effect on opioid-induced analgesia and produced more severe side effects such as dizziness after the procedure.[5] Consequently, it was dropped from clinical development,[6] although it is still used in scientific research.[7]
^Hering W, Ihmsen H, Albrecht S, Schwilden H, Schüttler J (December 1996). "[RO 48-6791--a short acting benzodiazepine. Pharmacokinetics and pharmacodynamics in young and old subjects in comparison to midazolam]" [RO 48-6791--a short acting benzodiazepine. Pharmacokinetics and pharmacodynamics in young and old subjects in comparison to midazolam]. Der Anaesthesist (in German). 45 (12): 1211–4. doi:10.1007/s001010050360. PMID9065257. S2CID29508.
^Tang J, Wang B, White PF, Gold M, Gold J (October 1999). "Comparison of the sedation and recovery profiles of Ro 48-6791, a new benzodiazepine, and midazolam in combination with meperidine for outpatient endoscopic procedures". Anesthesia and Analgesia. 89 (4): 893–8. doi:10.1097/00000539-199910000-00014. PMID10512261.
^Gold ME, Todd SA, Spiegler C, Gold JA (December 1999). "When the drug trial fails: an approach to clinical drug studies". AANA Journal. 67 (6): 505–12. PMID10876442.