In Collaboration With

THERAPEUTICS

Brands

• Romazicon
• Anexate
• Lanexat
• see index for additional brand names

Generic?

• No

Class

• Benzodiazepine receptor antagonist

Commonly Prescribed For

• (bold for FDA approved)
• Reversal of sedative effects of benzodiazepines after general anesthesia has been induced and/or maintained with benzodiazepines
• Reversal of sedative effects of benzodiazepines after sedation has been produced with benzodiazepines for diagnostic and therapeutic procedures
• Management of benzodiazepine overdose
• Reversal of conscious sedation induced with benzodiazepines (pediatric patients)

How The Drug Works

• Blocks benzodiazepine receptors at GABA-A ligand-gated chloride channel complex, preventing benzodiazepines from binding there

How Long Until It Works

• Onset of action 1–2 minutes; peak effect 6–10 minutes

If It Works

• Reverses sedation and psychomotor retardation rapidly, but may not restore memory completely
• Patients treated for benzodiazepine overdose may experience CNS excitation
• Patients who receive flumazenil to reverse benzodiazepine effects should be monitored for up to 2 hours for resedation, respiratory depression, or other lingering benzodiazepine effects
• Flumazenil has not been shown to treat hypoventilation due to benzodiazepine treatment

If It Doesn’t Work

• Sedation is most likely not due to a benzodiazepine, and treatment with flumazenil should be discontinued and other causes of sedation investigated

Best Augmenting Combos for Partial Response or Treatment-Resistance

• None – flumazenil is basically used as a monotherapy antidote to reverse the actions of benzodiazepines

Tests

• None for healthy individuals