Drug reference

Flumazenil

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1461, 1462

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Reversal of sedative effects of benzodiazepines in anaesthesia and clinical procedures ▶BY INTRAVENOUS INJECTION ▶Adult: 200 micrograms, dose to be administered over 15 seconds, then 100 micrograms every 1 minute if required; usual dose 300–600 micrograms; maximum 1 mg per course Reversal of sedative effects of benzodiazepines in intensive care ▶BY INTRAVENOUS INJECTION ▶Adult: 300 micrograms, dose to be administered over 15 seconds, then 100 micrograms every 1 minute if Emergency treatment of poisoning required; maximum 2 mg per course Reversal of sedative effects of benzodiazepines in intensive care (if drowsiness recurs after injection) ▶INITIALLY BY INTRAVENOUS INFUSION ▶Adult: 100–400 micrograms/hour, adjusted according to response, alternatively (by intravenous injection) 300 micrograms, adjusted according to response

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Contra Indications

Life-threatening condition (e.g. raised intracranial pressure, status epilepticus) controlled by benzodiazepines

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Cautions

Avoid rapid injection following major surgery. avoid rapid injection in high-risk or anxious patients. benzodiazepine dependence (may precipitate withdrawal symptoms). elderly. ensure neuromuscular blockade cleared before giving. head injury (rapid reversal of benzodiazepine sedation may cause convulsions). history of panic disorders (risk of recurrence). prolonged benzodiazepine therapy for epilepsy (risk of convulsions). short-acting (repeat doses may be necessary— benzodiazepine effects may persist for at least 24 hours)

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Safety

Important Safety Information

Flumazenil should only be administered by, or under the direct supervision of, personnel experienced in its use.

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Side Effects

▶Common or very common Anxiety. diplopia. dry mouth. eye disorders. ﬂushing. headache. hiccups. hyperhidrosis . hyperventilation. hypotension. insomnia. nausea. palpitations. paraesthesia. speech disorder. tremor. vertigo. vomiting ▶Uncommon Abnormal hearing. arrhythmias. chest pain. chills. cough. dyspnoea. nasal congestion. seizure (more common in patients with epilepsy) ▶Frequency not known Withdrawal syndrome

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Pregnancy

Not known to be harmful.

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Breast Feeding

Avoid breast-feeding for 24 hours.

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Hepatic Impairment

Manufacturer advises caution (risk of increased half-life). Dose adjustments Manufacturer advises cautious dose titration.

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Dose and formulations

Directions For Administration

For continuous intravenous infusion, dilute with Glucose 5% or Sodium Chloride 0.9%.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Solution for injection ▶Flumazenil (Non-proprietary) Flumazenil 100 microgram per 1 ml Flumazenil 500micrograms/5ml solution for injection ampoules | 5 ampoule P £72.46 (Hospital only) | 5 ampoule P £65.50– £70.00 | 10 ampoule P £140.00 3.2 Digoxin toxicity ANTIDOTES AND CHELATORS › ANTIBODIES

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Dose text by age group

Adult

200 micrograms, dose to be administered over

First-line fragment. Read the complete Indications and Dose section above.

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Adult

300 micrograms, dose to be administered over

First-line fragment. Read the complete Indications and Dose section above.

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Adult

100–400 micrograms/hour, adjusted according

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1461

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Flumazenil

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1461, 1462

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 1461

Contra Indications

Life-threatening condition (e.g. raised intracranial pressure, status epilepticus) controlled by benzodiazepines

PDF page 1461

Cautions

PDF page 1461

Safety

Important Safety Information

Flumazenil should only be administered by, or under the direct supervision of, personnel experienced in its use.

PDF page 1461

Side Effects

PDF page 1461

Pregnancy

Not known to be harmful.

PDF page 1461

Breast Feeding

Avoid breast-feeding for 24 hours.

PDF page 1461

Hepatic Impairment

Manufacturer advises caution (risk of increased half-life). Dose adjustments Manufacturer advises cautious dose titration.

PDF page 1461

Dose and formulations

Directions For Administration

For continuous intravenous infusion, dilute with Glucose 5% or Sodium Chloride 0.9%.

PDF page 1461

Medicinal Forms

PDF page 1462

Dose text by age group

Adult

200 micrograms, dose to be administered over

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1461

Adult

300 micrograms, dose to be administered over

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1461

Adult

100–400 micrograms/hour, adjusted according

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1461

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.