FLUMAZENIL

Indications & Dose:

Complete or partial reversal of sedative effects of benzodiazepines

Adult

Reversal of conscious sedation:

IV 0.2 mg (2 ml) initially over 15 sec, repeat at 60 sec intervals prn to a max total dose of 1 mg (10 ml)

Suspected benzodiazepine overdose:

IV 0.2 mg (2 ml) given over 30 sec; wait 30 sec, then give 0.3 mg (3 ml) over 30 sec if consciousness does not occur; further doses of 0.5 mg ( 5 ml) can be given over 30 sec at intervals of 1 min up to cumulative dose of 3 mg; patients with a partial response at 3 mg may require additional titration up to a total dose of 5 mg (administered slowly in the same manner) 

Contraindications:

Serious cyclic antidepressant overdose, patients given benzodiazepine for control of life threatening condition. 

Side Effects:

Cautions:

Precautions:

 Children, elderly, renal disease, seizure disorders, head injury, labor and delivttry, hepatic disease, hypoventilation, panic disorder, drug and alcohol dependency, ambulatory patients (resedation may occur)

Interaction:

DRUGS

benzodiazepines: Benzodiazepine with-drawal symptoms, including seizures nonbenzodiazepine

agonists: Loss of effec-tiveness of these drugs

tetracyclic or tricyclic antidepressant overdose: High risk of seizures

FOODS

all foods: Increased flumazenil clearance (by half) with food ingestion during I.V. injection

Warnings:

Adverse Effects:

Lactations:

Excretion into breast milk unknown; use caution in nursing mothers 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Agitation, confusion, dizziness, emotional lability, headache, seams, somnolence

CV: Bradycardia, dysrhythmias, chest pain, cutaneous vasodilation, hypertension, palpitations, tachycaraia

EENT: Abnormal vision; blurred vision, tinnitus

GI: Hiccups, nausea, vomiting

SKIN: Increased sweating

MISC: Inj site pain, fatigue

Adverse Reactions 

CNS: Agitation, anxiety, ataxia, confusion, dizziness, drowsiness, emotional lability, fatigue, headache, hypoesthesia, insomnia, paresthesia, resedation, seizures, tremor, vertigo

CV: Hot flashes, hypertension, palpitations

EENT: Blurred vision, diplopia, dry mouth

GI: Nausea, vomiting

RESP: Dyspnea, hyperventilation, hypoven-tilation

SKIN: Diaphoresis, flushing, rash

Other: Injectionsite pain and thrombo-phlebitis

Patient And Carer Advice: