Generic Name and Formulations:
Flumazenil 0.1mg/mL; IV inj.
Various generic manufacturers
Indications for Flumazenil:
Reversal of benzodiazepine sedative effects in overdose, general anesthesia or conscious sedation.
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.
<1yr: not recommended. 1–17yrs: for reversal of benzodiazepine-induced conscious sedation only. See full labeling.
Patients treated with benzodiazepines for life threatening conditions. Mixed overdose patients when seizures likely (esp. cyclic antidepressants).
Occurrence of seizures.
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.
Avoid use until neuromuscular blockade reversed. Avoid alcohol, sedatives for 18–24hrs after treatment. Potentiates toxicity of cyclic antidepressant or mixed drug overdose.
Seizures, local reactions, dizziness, increased sweating, headache, blurred vision, GI upset, agitation, benzodiazepine withdrawal syndrome.
Clinical Pain Advisor Articles
- Virtual Reality May Effectively Reduce Sensory, Affective, and Cognitive Pain During Labor
- Suprazygomatic Sphenopalatine Ganglion Block May Quickly Relieve Status Migrainosus Pain
- Reducing Mortality After Overdose: Is Treatment for Opioid Use Disorder Effective?
- A Physician's Guide to Incorporating Patient Spirituality in Practice
- Low Literacy Self-Management Program for Chronic Pain May Be Effective
- Neuropathic Pain Medications
- Higher Buprenorphine Dose May Not Increase Severity of Neonatal Abstinence Syndrome
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Ketamine Infusions May Be Effective for Refractory Headache
- Physical, Psychosocial Activity May Be Protective Against Development of Chronic Pain in Older Adults
- The Challenge of Compassion in Modern Healthcare Settings
- Republican Opposition to Obamacare: What's Done, What's to Come
- Lowering Default Pill Counts in EMRs May Effectively Reduce Postoperative Opioid Prescription Numbers
- Steps Taken to Increase Use of Electronic Tools in Medicine
- Daily and Retrospective Pain Measurements Comparable in Hip Osteoarthritis