Poisoning/overdose:
Indications for Flumazenil:
Reversal of benzodiazepine sedative effects in overdose, general anesthesia or conscious sedation.
Adult:
Overdose: Give dose over 30 seconds by IV infusion. Initially: 0.2mg. After 30 seconds (if needed), 0.3mg. Then 0.5mg at 60 second intervals up to 3mg cumulative dose. Usual range: 1–3mg. If partial response occurs at 3mg cumulative dose, may titrate up to 5mg cumulative dose. Conscious sedation, general anesthesia, resedation: see full labeling.
Children:
<1yr: not recommended. 1–17yrs: for reversal of benzodiazepine-induced conscious sedation only. See full labeling.
Contraindications:
Patients treated with benzodiazepines for life threatening conditions. Mixed overdose patients when seizures likely (esp. cyclic antidepressants).
Boxed Warning:
Occurrence of seizures.
Warnings/Precautions:
Monitor for resedation (at least 2hrs), respiratory depression, other residual benzodiazepine effects, seizures. Seizure disorders or risk. Drug or alcohol dependence. Head injury. Panic disorder. Hepatic disease. Counsel on post-procedure period (see full labeling). Labor & delivery: not recommended. Pregnancy (Cat.C). Nursing mothers.
Pharmacologic Class:
Benzodiazepine antagonist.
Interactions:
Avoid use until neuromuscular blockade reversed. Avoid alcohol, sedatives for 18–24hrs after treatment. Potentiates toxicity of cyclic antidepressant or mixed drug overdose.
Adverse Reactions:
Seizures, local reactions, dizziness, increased sweating, headache, blurred vision, GI upset, agitation, benzodiazepine withdrawal syndrome.
How Supplied:
Contact supplier.
