Possible concomitant: Cyclic antidepressant overdoseĬhronic benzodiazepine user patients receiving a benzodiazepine for life-threatening condition (eg, intracranial pressure control, status epilepticus) Cautions Hypersensitivity to flumazenil or benzodiazepines

Practitioners should individualize the dosage of flumazenil and be prepared to manage seizures. These are most frequent in patients who have been on benzodiazepines for long-term sedation or in overdose cases where patients are showing signs of serious cyclic antidepressant overdose. The use of flumazenil has been associated with seizures. Hepatic impairment: Initial dose adjustment not necessary reduce dose or frequency of subsequent doses Slow infusion of lowest dose required to decrease adverse effects Dosing Modifications Rarely patient may require titration up to total dose 5 mg IF no response after 5 min, sedation unlikely to be secondary to benzodiazepines Dosing Considerations In the event of resedation, may repeat dose at 20-min intervals if needed not to exceed 1 mg (administered as 0.5 mg/min) administered at any one time and no more than 3 mg/hr IF no response after 30 sec, administer 0.3 mg over 30 sec 1 min later IF no response, repeat dose of 0.5 mg IV over 30 sec at 1-min intervals to max cumulative dose of 3 mg/hr IF resedation occurs, may repeat doses at 20-min intervals not to exceed 1 mg/dose or 3 mg/hr Benzodiazepine Overdose IF after 45 sec no response, administer 0.2 mg again over 1 min may repeat at 1 min intervals not to exceed 4 doses (1 mg) Reversal of Conscious Sedation and General Anesthesia Dosage Forms & Strengths injectable solution

Benzodiazepine antidote dose