Flumazenil Brand Name– Romazicon
What is Flumazenil
Flumazenil is a parenteral benzodiazepine antagonist. It is an imidazobenzodiazepine derivative.
Flumazenil is used to treat benzodiazepine overdose and to reverse benzodiazepine sedation during anesthesia.
Flumazenil will also antagonize the sedative actions of zolpidem and eszopiclone.
Flumazenil is administered by rapid IV injection because it is highly irritating, and care should be taken to avoid extravasation.
In pediatric patients, the intravenous formulation has also been administered intranasally and rectally; these routes of administration are not FDA-approved.
Flumazenil does not reverse the actions of barbiturates, opiate agonists, or tricyclic antidepressants and is contraindicated in patients showing signs of cyclic antidepressant toxicity
Indications
- benzodiazepine toxicity
- sedation reversal
For sedation reversal when sedation is secondary to benzodiazepine therapy
Side Effects
- agitation
- anxiety
- arrhythmia exacerbation
- asthenia
- ataxia
- blurred vision
- bradycardia
- chest pain (unspecified)
- confusion
- delirium
- depression
- diplopia
- dizziness
- drowsiness
- dysphonia
- dysphoria
- dyspnea
- emotional lability
- euphoria
- fatigue
- flushing
- headache
- hearing loss
- hiccups
- hot flashes
- hyperacusis
- hyperhidrosis
- hypertension
- hyperventilation
- hypoesthesia
- injection site reaction
- insomnia
- lacrimation
- malaise
- nausea
- palpitations
- paranoia
- paresthesias
- peripheral vasodilation
- phlebitis
- rash
- seizures
- shivering
- sinus tachycardia
- tinnitus
- tremor
- ventricular tachycardia
- vertigo
- vomiting
- withdrawal
- xerostomia
Monitoring Parameters
- ECG
- neurologic function
Contraindications
- alcoholism
- anxiety
- benzodiazepine dependence
- benzodiazepine hypersensitivity
- breast-feeding
- driving or operating machinery
- head trauma
- hepatic disease
- increased intracranial pressure
- labor
- obstetric delivery
- overdose
- panic disorder
- pregnancy
- pulmonary disease
- respiratory depression
- seizure disorder
- seizures
- status epilepticus
- substance abuse
Interactions
- Alprazolam
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Benzodiazepines
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Clobazam
- Clomipramine
- Clonazepam
- Clorazepate
- Desipramine
- Diazepam
- Doxepin
- Estazolam
- Eszopiclone
- Flurazepam
- Imipramine
- Lorazepam
- Maprotiline
- Midazolam
- Nalmefene
- Nortriptyline
- Oxazepam
- Perphenazine; Amitriptyline
- Protriptyline
- Quazepam
- Temazepam
- Triazolam
- Tricyclic antidepressants
- Trimipramine
- Zaleplon
- Zolpidem