Flumazenil

Question 1

What is the indication and dosing for flumazenil?

Answer 1

Benzodiazepine overdose - initially give 0.2mg iv, then 0.5mg every minute until max dose 3mg

In hepatic impairment, first dose is the same but reduce frequency or dose of subsequent deliveries

Question 2

Contraindications of flumazenil

Answer 2

Benzodiazepine dependence - beware use in ICU as sometimes unrecognised dependence

Question 3

Side effects of flumazenil

Answer 3

Seizures, sweating, headache, nausea, vasodilation

Question 4

What interacts with flumazenil?

Answer 4

Beware mixed overdoses, especially TCAs, as reversal of benzodiazepine effect can unmask toxic effects of other drug

Question 5

How does flumazenil work?

Answer 5

Competitively inhibits the GABA receptor/benzodiazepine binding site