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SIMODA

SIMODA

Ask a doctor about a prescription for SIMODA

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Doctor

Anastasiia Hladkykh

Psychiatry15 years of experience

Dr Anastasiia Hladkykh is a physician-psychotherapist and psychologist with over 14 years of experience working with individuals struggling with various types of addictions and their families. She provides online consultations for adults, combining medical knowledge with deep psychological support and practical tools.

Key areas of expertise:

  • Addiction treatment: alcohol and drug dependence, gambling addiction, compulsive behaviours, codependent relationships.
  • Support for families of addicted individuals, behavioural correction within the family system, guidance for maintaining remission.
  • Mental health: depression, bipolar disorder, obsessive-compulsive disorder (OCD), anxiety disorders, phobias, PTSD, generalised anxiety, emotional trauma, and the psychological impact of loss or emigration.
  • Psychoeducation: explaining complex mental health concepts in simple language, helping patients and their families understand diagnoses and treatment steps.
Therapeutic approach:
  • Client-centred, straightforward, and empathetic – focused on practical outcomes and emotional stabilisation.
  • Prescribes medications when needed, but always aims to minimise unnecessary pharmaceutical use.
  • Certified in multiple evidence-based methods: CBT, NLP (Master Practitioner), Ericksonian hypnosis, symbol drama, art therapy, and systemic therapy.
  • Each consultation results in a clear, structured plan – patients leave knowing exactly what to do next.
Experience and background:
  • Member of the German association Gesundheitpraktikerin and the NGO “Mit dem Sonne in jedem Herzen.”
  • More than 18 publications in international peer-reviewed journals, translated into several languages.
  • Volunteer work with Ukrainian refugees and military personnel at the University Clinic of Regensburg.
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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use SIMODA

INSTRUCTIONS for medical use of the medicinal product FLUMAZENIL-VISTA (FLUMAZENIL-VISTA)

Composition

active substance: flumazenil; 1 ml of solution contains 0.1 mg of flumazenil; excipients: sodium chloride, disodium edetate, glacial acetic acid, sodium hydroxide, water for injections.

Pharmaceutical form

Solution for injection.

Main physical and chemical properties

Transparent, colorless solution.

Pharmacotherapeutic group

Other therapeutic agents. Antidotes. ATC code V03AB25.

Pharmacological properties

Pharmacodynamics
Mechanism of action

Flumazenil is a benzodiazepine antagonist, an imidazobenzodiazepine derivative that, through competitive interaction, specifically blocks the effects of substances acting on the benzodiazepine receptor in the central nervous system (CNS). There have been reports of neutralization of paradoxical benzodiazepine reactions.

Pharmacodynamic effects

Experiments conducted on animals have shown that flumazenil does not block the effects of benzodiazepine receptor agonists, such as barbiturates, mimetics of gamma-aminobutyric acid, and adenosine receptor antagonists. Flumazenil blocks the action of non-benzodiazepine agonists, such as cyclopyrrolones (zoplicone) and triazolopyridazines. The hypnotic-sedative effects of benzodiazepines quickly disappear (within 1-2 minutes) after intravenous administration of flumazenil. Depending on the difference in elimination time between the agonist and antagonist, the effect may recur within several hours. Flumazenil may have slight agonistic (e.g., anticonvulsant) activity. Clinical efficacy and safety. Animal studies have shown that with prolonged treatment with flumazenil, a withdrawal syndrome developed, including seizures.

Pharmacokinetics
Distribution

Flumazenil is a weakly lipophilic base. Flumazenil is bound to approximately 50% of plasma proteins, of which 2/3 are bound to albumin. Flumazenil is intensely distributed in the extracellular space. During the distribution phase, the concentration of flumazenil in plasma decreases with a half-life of 4-5 minutes. The volume of distribution at steady-state concentration is 0.9-1.1 L/kg.

Metabolism

Flumazenil undergoes intensive metabolism in the liver. The most important inactive metabolite in plasma (in free form) and urine (in free and conjugated form) is carboxylic acid. The results of pharmacological tests have shown that this metabolite does not have agonistic or antagonistic benzodiazepine activity.

Elimination

Flumazenil is almost completely excreted in the urine. This indicates complete breakdown of the active substance in the body. Studies with a radiolabeled drug have shown that complete excretion occurs within 72 hours: 90-95% with urine and 5-10% with feces. Elimination is rapid, as evidenced by a short half-life (40-80 minutes). The total clearance of flumazenil is 0.8-1.0 L/h/kg, and metabolism occurs mainly in the liver.

Clinical characteristics

Indications

The medicinal product is used to partially or completely eliminate the central sedative effects of benzodiazepines in adults and children over 1 year of age. It can be used in anesthesia and intensive care.

Contraindications
  • Increased sensitivity to the active substance or to any of the components of the medicinal product.
  • Treatment of potentially life-threatening conditions with benzodiazepines (e.g., control of intracranial pressure or epileptic status).
  • Severe intoxication caused by cyclic antidepressants (seizures, focal seizures, QRS prolongation, arrhythmia, mydriasis, anticholinergic symptoms).
Interaction with other medicinal products and other types of interactions

Interaction studies were conducted only in adult patients. Flumazenil suppresses the central effects of benzodiazepines by competitive inhibition at the receptor level. It also blocks the action of non-benzodiazepine agonists (e.g., zoplicone, triazolopyridazines) on benzodiazepine receptors. However, flumazenil does not block the action of medicinal products that do not work through this mechanism. No interaction with other CNS depressants has been observed.

Special instructions

Monitoring

When using flumazenil to eliminate sedation caused by benzodiazepines, it is necessary to monitor the dose, vital signs (electrocardiogram (ECG)), pulse, oximetry, concentration of the patient's attention, and other vital signs (such as heart rate, respiratory rate, and blood pressure) for a long time, as well as the duration of the effect of the used benzodiazepine for the occurrence of symptoms of repeated sedation, difficulty breathing, or other signs of residual benzodiazepine effect.

Anxiety

It is necessary to carefully select the dosage of flumazenil for patients who suffer from preoperative anxiety or have a history of chronic or episodic anxiety.

Postoperative pain

Postoperative pain should be taken into account. It may be better to keep the patient sedated.

Pediatric use

Due to the likelihood of repeated sedation and difficulty breathing in children who have been sedated with midazolam, it is necessary to carefully monitor them for at least 2 hours after administration of flumazenil.

Overdose

Symptoms. Even when used in higher doses than recommended (up to 100 mg of flumazenil), symptoms of overdose have not been observed.

Adverse reactions

Immune system disorders
oftenhypersensitivity reactions, anaphylactic shock
Psychiatric disorders
oftenanxiety, insomnia, drowsiness, emotional lability
rarelyfear
frequency unknownpsychic changes, euphoria, fatigue, pathological crying, aggressive reactions, panic attacks; withdrawal syndrome: agitation, anxiety, emotional lability, confusion, sensory disturbances
Nervous system disorders
oftenheadache, vertigo, agitation, tremor, dry mouth, rapid breathing, speech disorders, paresthesia
rarelyseizures (mainly in patients with epilepsy, severe liver failure, especially after treatment with benzodiazepines or in case of overdose with several medicinal products)
frequency unknownspontaneous movements
Eye disorders
oftendiplopia, strabismus, increased lacrimation
Ear and labyrinth disorders
rarelyhearing impairment
Cardiovascular disorders
oftenincreased heart rate, flushing, hypotension, orthostatic hypertension, transient hypertension (upon awakening)
rarelytachycardia or bradycardia, extrasystole
Respiratory, thoracic, and mediastinal disorders
rarelydyspnea, cough, nasal congestion, chest pain
Gastrointestinal disorders
very oftennausea (during anesthesia, especially when used with opioids)
oftenvomiting (during anesthesia, especially when used with opioids), hiccups
Skin and subcutaneous tissue disorders
oftenincreased sweating
rarelypallor
frequency unknownheat flushes to the face
General disorders and administration site conditions
oftenfatigue, pain at the injection site
rarelytrembling
frequency unknownincreased pain sensation, weight gain, chills

Shelf life

3 years.

Storage conditions

No special storage conditions are required for the medicinal product. Store in a place inaccessible to children.

Packaging

5 ml in an ampoule; 5 or 10 ampoules in a cardboard pack.

Release category

By prescription.

Manufacturer

LABORATORIO REIG JOFRÉ, S.A.

Location of the manufacturer and its business address

C/Gran Capitán, 10, Sant Joan Despí, Barcelona, 08970, Spain

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Online doctors for SIMODA

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for SIMODA – subject to medical assessment and local rules.

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Farouk Laafif

Psychiatry4 years of experience

Dr. Farouk Laafif is a psychiatrist providing online consultations for adults and adolescents facing emotional or mental health challenges. His clinical approach integrates psychopharmacology with psychotherapy, with a strong focus on the connection between mental and physical well-being.

He offers compassionate, evidence-based support for individuals dealing with:

  • depression and anxiety disorders
  • bipolar affective disorder
  • schizophrenia and other psychotic conditions
  • psychosomatic symptoms and chronic stress
  • treatment planning and medication adjustment
Dr. Laafif combines scientific expertise with human empathy, helping patients restore emotional balance, improve daily functioning, and regain confidence in their recovery journey.
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5.0(3)
Doctor

Anastasiia Hladkykh

Psychiatry15 years of experience

Dr Anastasiia Hladkykh is a physician-psychotherapist and psychologist with over 14 years of experience working with individuals struggling with various types of addictions and their families. She provides online consultations for adults, combining medical knowledge with deep psychological support and practical tools.

Key areas of expertise:

  • Addiction treatment: alcohol and drug dependence, gambling addiction, compulsive behaviours, codependent relationships.
  • Support for families of addicted individuals, behavioural correction within the family system, guidance for maintaining remission.
  • Mental health: depression, bipolar disorder, obsessive-compulsive disorder (OCD), anxiety disorders, phobias, PTSD, generalised anxiety, emotional trauma, and the psychological impact of loss or emigration.
  • Psychoeducation: explaining complex mental health concepts in simple language, helping patients and their families understand diagnoses and treatment steps.
Therapeutic approach:
  • Client-centred, straightforward, and empathetic – focused on practical outcomes and emotional stabilisation.
  • Prescribes medications when needed, but always aims to minimise unnecessary pharmaceutical use.
  • Certified in multiple evidence-based methods: CBT, NLP (Master Practitioner), Ericksonian hypnosis, symbol drama, art therapy, and systemic therapy.
  • Each consultation results in a clear, structured plan – patients leave knowing exactly what to do next.
Experience and background:
  • Member of the German association Gesundheitpraktikerin and the NGO “Mit dem Sonne in jedem Herzen.”
  • More than 18 publications in international peer-reviewed journals, translated into several languages.
  • Volunteer work with Ukrainian refugees and military personnel at the University Clinic of Regensburg.
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Dr Daria Portnova is a psychiatrist and psychotherapist with over 30 years of clinical experience. She works with adults and adolescents aged 14 and over, providing online psychiatric and psychotherapeutic consultations.

In her practice, Dr Portnova supports patients facing the onset of mental health conditions, chronic psychiatric disorders, psychotic symptoms, trauma-related states, and complex emotional crises. Her work is structured and safety-focused, with an emphasis on stabilisation, accurate diagnosis, and long-term improvement in quality of life.

Patients consult Dr Daria Portnova for the following concerns:

  • existential crises and complex life situations;
  • loss, grief, and emotional exhaustion;
  • relationship difficulties, separation, and divorce;
  • psychological and psychiatric trauma, including complex PTSD (cPTSD);
  • anxiety disorders: generalised anxiety disorder and panic disorder;
  • social anxiety and social phobia;
  • obsessive-compulsive disorder (OCD);
  • sleep disorders;
  • depressive disorders;
  • bipolar affective disorder;
  • schizoaffective disorder;
  • schizophrenia;
  • personality disorders.
Dr Portnova combines psychiatric assessment with a psychotherapeutic approach. She works with evidence-based methods, including cognitive behavioural therapy (CBT) and third-wave approaches such as ACT, FACT, and CFT. Consultations are focused on clear clinical understanding, practical recommendations, and ongoing support over time.
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Main areas of support:

  • Depression and burnout
  • Anxiety, panic attacks, phobias
  • Post-traumatic stress disorder (PTSD)
  • Psychosomatic symptoms and sleep disturbances
  • Health anxiety (hypochondria)
  • Mental health support in chronic physical illness
  • Adjustment disorders and low self-esteem
Dr Kondratiuk focuses on creating a safe and respectful therapeutic environment where patients feel heard and supported. Her goal is to help each person achieve lasting improvements in their mental well-being.
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Dr. Ilyasov helps patients in the following cases:

  • Chronic headaches (migraine, tension-type headache), back pain, neuropathic pain, dizziness, numbness in limbs, coordination disorders.
  • Anxiety disorders (panic attacks, generalized anxiety disorder), depression (including atypical and treatment-resistant forms), sleep disturbances (insomnia, hypersomnia, nightmares), stress, burnout.
  • Chronic pain syndromes and psychosomatic symptoms (e.g., irritable bowel syndrome related to stress, vegetative-vascular dystonia).
  • Behavioral disorders and concentration difficulties in adolescents (including ADHD, autism spectrum disorders), nervous tics.
  • Memory impairments, phobias, obsessive-compulsive disorder (OCD), emotional swings, and support for post-traumatic stress disorder (PTSD).

Thanks to his dual specialization in neurology and psychiatry, Dr Sergey Ilyasov offers integrated and evidence-based care for complex conditions requiring a multidisciplinary approach. His consultations focus on accurate diagnosis, development of an individualized treatment plan (including pharmacotherapy and psychotherapeutic methods), and long-term support adapted to each patient's unique needs.

Book an online consultation with Dr. Sergey Ilyasov to receive qualified assistance and improve your well-being today.

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She specialises in consultations and ongoing support for a wide range of mental health concerns, including:

  • Mood disorders: depression, bipolar disorder, postpartum depression.
  • Anxiety disorders: generalised anxiety, OCD, panic attacks, phobias.
  • Post-traumatic stress disorder (PTSD) and complex PTSD.
  • Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Assessment is provided only after an initial psychiatric evaluation and during a follow-up appointment.
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  • Schizophrenia spectrum and related conditions.

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