In addition to these human case reports, rat and dog data suggest the increased risk of seizure when flumazenil is given. Lorazepam, phenytoin, and phenobarbital were administered however, seizures persisted for 4 hours, resulting in rhabdomyolysis, acute renal failure, severe brain damage, and death.Īnother set of authors reported the occurrence of a generalized tonic-clonic seizure in a pediatric patient following the administration of flumazenil.Ī review of 43 seizures reported with flumazenil identified that almost half of the cases involved co-ingestion of a pro-convulsant agent (such as a tricyclic antidepressant).

The patient developed refractory seizures. This risk was described in case reports in the early 1990’s.Ī 39-year-old woman who overdosed on benzodiazepines and tricyclic antidepressants was treated with flumazenil. Many providers insist on not using flumazenil in benzodiazepine overdose scenarios due to the risk of precipitating acute benzodiazepine withdrawal and seizures. The onset of action is 1-2 minutes and the effect lasts for about 1 hour.

The usual dose is 0.2 mg over 15-30 seconds, repeated every minute if needed. – Reversal of conscious sedation and general anesthesia

The approved indications for flumazenil are: It is classified as an antidote to benzodiazepines. Flumazenil is a competitive benzodiazepine receptor inhibitor.

Benzodiazepine overdose antidote