Flumazenil

>10%

Nausea and vomiting (11%)

1-10%

Dizziness (10%)

Abnormal/blurred vision (3-9%)

Agitation (3-9%)

Dyspnea (3-9%)

Hyperventilation (3-9%)

Pain at injection site (3-9%)

Xerostomia (3-9%)

Diaphoresis (1-3%)

Emotional lability (1-3%)

Fatigue (1-3%)

Headache (1-3%)

Paresthesia (1-3%)

Tremor (1-3%)

Weakness (1-3%)

<1%

Delirium

Abnormal hearing

Junctional tachycardia

Thick tongue

Tinnitus

Coldness sensation

Generalized seizure

Flumazenil is injected into a vein through an IV. A healthcare provider will give you this injection.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when flumazenil is injected.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely after you receive flumazenil.

You may have temporary amnesia while you are waking up from sedation. You may not remember everything going on around you for up to 2 hours.

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Because you will receive flumazenil in a clinical setting, you are not likely to miss a dose.

Before taking flumazenil, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to flumazenil or any of its ingredients
• are allergic to benzodiazepines
• have liver problems
• have heart problems
• have lung problems
• are taking benzodiazepines
• are taking a class of medicines called tricyclic antidepressants
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

If flumazenil is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Flumazenil is injected into a vein through an IV. A healthcare provider will give you this injection.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when flumazenil is injected.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely after you receive flumazenil.

You may have temporary amnesia while you are waking up from sedation. You may not remember everything going on around you for up to 2 hours.

Because you will receive flumazenil in a clinical setting, you are not likely to miss a dose.

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Receiving flumazenil after taking large doses of certain antidepressants can cause dangerous or life-threatening side effects. Tell your doctor before you receive flumazenil if you have recently taken an antidepressant such as amitriptyline, doxepin, clomipramine, desipramine, imipramine, or nortriptyline.

Other drugs may interact with flumazenil, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Benzodiazepine antagonist.1

Extensively metabolized in the liver, but the precise enzymes responsible are unknown.1

Specific Drugs

• Antagonizes CNS effects (e.g., sedation, impaired recall, psychomotor impairment, respiratory depression) of benzodiazepines by competitively inhibiting the activity of the drugs at the benzodiazepine recognition site on the GABA/benzodiazepine receptor complex.1

• Does not antagonize the CNS effects of drugs affecting GABA-ergic neurons by means other than the benzodiazepine receptor (e.g., barbiturates, alcohol, general anesthetics) and does not reverse the effects of opioids.1

• Risk of impaired memory and judgment.1

• Risk of increased adverse effects in regular users of benzodiazepines; importance of informing clinicians of history of benzodiazepine, alcohol, and/or sedative use prior to use of flumazenil.1

• Importance of avoiding activities that require complete alertness, and not operating hazardous machinery or a motor vehicle until at least 18–24 hours after discharge and it is certain that no residual sedative effects of the benzodiazepine remain.1

• Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.1

• Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as concomitant illnesses.1

• Importance of informing patients of other important precautionary information.1 (See Cautions.)

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

(FLOO may ze nil)

1-2 minutes; 80% response within 3 minutes; Peak effect: 6-10 minutes

Moderate: Mean total clearance decreased 40% to 60%. Severe: Mean total clearance decreased 75%.

No adjustments recommended