Flumazenil

Emergency Drugs

Emergency Drugs · Benzodiazepine antagonist

Flumazenil

Dose

0.2 mg IV over 15 s, repeat q1min up to 1 mg total

Mechanism

Competitive antagonist at GABA-A benzodiazepine binding site

Indications

  • Iatrogenic benzodiazepine over-sedation

Contraindications

  • Chronic benzodiazepine use
  • Mixed overdose with TCA
  • Known seizure disorder

Use

Use cautiously — may precipitate seizures.

Monitoring

GCS, RR, seizures, re-sedation (short t½).

Side effects

  • Seizures
  • Re-sedation
  • Arrhythmia

Related in WardRound

Always confirm dose against your local formulary / BNF before prescribing.

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