What Is Flumazenil Used For

Flumazenil is a drug used to opposite certain kinds of sedation given for diagnostic or surgical procedures. It tin too be a lifesaving handling for benzodiazepine drug overdose.

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What Are Benzodiazepines?

To empathise the uses of flumazenil, it'due south helpful to empathize a little nearly benzodiazepines. Benzodiazepines are a grade of drugs that activate a type of receptor plant on many cells of the nervous system, called the GABA receptor. In general, binding to these receptors produces a calming outcome on the encephalon.

These drugs are sometimes prescribed for a diverseness of dissimilar wellness weather condition. Some examples are:

• Insomnia
• Feet
• Epilepsy
• General muscle relaxation
• Muscle spasticity (from a key nervous system problem)

These drugs are also used for sedation and relaxation during medical procedures (often in addition to other types of drugs).

Many drugs that end with "pam" or "lam" are benzodiazepines. Some examples include:

• Diazepam (Valium)
• Lorazepam (Ativan)
• Clonazepam (Klonopin)
• Alprazolam (Xanax)
• Flurazepam (Dalmane)

While benzodiazepines take positive uses, they can produce undesirable side effects in sure situations. More importantly, they tin be life-threatening when taken in also big doses, or when taken in combination with sure other drugs. That's why flumazenil is such an important drug.

What Is Flumazenil?

Flumazenil (trademarked every bit Romazicon and Anexate) is a benzodiazepine adversary, a blazon of drug that counteracts the effects of benzodiazepines. Information technology does this by helping block the bounden of benzodiazepine drugs to the GABA receptor. Information technology tin be given as an intravenous injection or a continuous intravenous infusion. Flumazenil is approved for use in both adults and in children.

Who Might Need It

Typically, flumazenil is not a drug that people take over the long term. Nearly commonly it is used in one of two situations: afterwards a medical procedure or in response to a benzodiazepine overdose.

After a Medical Procedure

Benzodiazepines and related drugs are frequently used every bit role of diagnostic or surgical procedures. For example, you lot might be given a benzodiazepine as part of sedation for a colonoscopy to reduce discomfort. This is sometimes called "conscious sedation" because you aren't completely unconscious during the procedure.

Other times you might need full general anesthesia, which provides deep sedation for a more than involved surgical process. In this case, yous won't have any consciousness at all during the procedure. The diverse drugs used during anesthesia (which may include benzodiazepines) will ensure that yous don't experience pain while information technology is happening.

People who receive conscious sedation or general anesthesia feel groggy and sedated afterward because information technology takes a while for the medications used during the process to article of clothing off. This can take several hours or more than. During this time, it isn't safe to bulldoze or exercise other activities that require full alertness. In some cases, flumazenil can assistance decrease the recovery time needed to feel normal. People taking flumazenil may experience more than alert more chop-chop, compared to people who don't accept flumazenil. Flumazenil is not as effective at reducing sedation if you accept received not-benzodiazepine drugs for sedation likewise as benzodiazepines.

Benzodiazepine Overdose

Flumazenil is as well an essential handling for people who have overdosed on benzodiazepine drugs. This might happen if a person accidentally takes likewise much of a prescribed drug, or if a person is suicidal.

It is important to seek medical treatment right away if an overdose is suspected because at too high doses benzodiazepines can suppress animate and lead to expiry. Flumazenil is not effective in treating overdose caused by non-benzodiazepine drugs.

Currently, the only uses of flumazenil canonical by the Food and Drug Administration (FDA) are for reversal of post-procedural sedation and for treatment of benzodiazepine overdose. Yet, it is sometimes prescribed for other medical problems "off-label." That is, your healthcare provider may recall there are good reasons that the medicine might be helpful, but the FDA hasn't done all the studies needed to corroborate the drug in that setting. Some of these other weather condition include:

• Alcohol withdrawal syndrome
• Hepatic encephalopathy
• Drug activity reversal of other drugs (such as baclofen)
• Stupor of unknown origin

Flumazenil may besides be of benefit in helping people who have become dependent on benzodiazepines come up off these drugs more comfortably and hands.

How Quickly Does It Piece of work?

Flumazenil acts quickly—it merely takes a minute or two to start to work, and its superlative effect occurs in less than 10 minutes. Because of this, information technology's sometimes necessary to carefully monitor someone who has been given flumazenil. On the one hand, a patient might end upward needing more than than i dose (for instance, to annul overdose symptoms). On the other hand, if a person is given also much flumazenil, this can crusade other serious problems, like seizures. Your healthcare provider will only administrate flumazenil if the potential benefits outweigh the risks.

Possible Side Effects

In certain circumstances, flumazenil may cause side effects. The well-nigh serious potential reactions are:

• Seizure
• Neurological Effects
• Dangerous heart rhythms

Other possible problems include:

• Re-sedation
• Nausea and vomiting
• Confusion
• Headache
• Dizziness
• Impaired thinking
• Chest hurting
• Heart rate that is likewise tedious or too fast
• Elevated blood force per unit area
• Blurred vision
• Reaction at the injection site
• Anxiety or agitation
• Increased sweating

Seizures are much more mutual in people who have been taking benzodiazepines for a long period of time, especially if those people have e'er had a seizure in the past. These people demand to be monitored carefully for at to the lowest degree two hours after they receive the drug. They should only be given the drug if it is deemed safe to do then. Healthcare professionals will apply the minimum necessary dose, to lower possible risks.

Who Shouldn't Take It

There are some contraindications that preclude some people from safely taking flumazenil. The drug should never be taken by:

• People who are hypersensitive to flumazenil or benzodiazepines
• People taking benzodiazepines to control a life-threatening condition (similar elevated pressure within the skull)
• Patients who have overdosed on cyclic antidepressant drugs (like amitriptyline)

Flumazenil has also not been studied for safety during pregnancy, then it should but be given if the potential benefits for an expecting female parent outweigh potential harms.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to back up the facts inside our manufactures. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Sharbaf Shoar N, Saadabadi A. Flumazenil. In: StatPearls.

2. Harvard Wellness Publishing. Benzodiazepines (and the alternatives).

3. Griffin CE, Kaye AM, Bueno FR, Kaye AD. Benzodiazepine pharmacology and central nervous system–mediated effects.The Ochsner Journal. 2013;13(2):214-223.

4. Mathus-Vliegen EM, de Jong L, Kos-Foekema HA. Significant and safe shortening of the recovery time after flumazenil-reversed midazolam sedation. Dig Dis Sci. 2014;59(8):1717-25. doi:10.1007/s10620-014-3061-2

5. An H, Godwin J. Flumazenil in benzodiazepine overdose.CMAJ. 2016;188(17-18):E537. doi:ten.1503/cmaj.160357

6. Goh ET, Andersen ML, Morgan MY, Gluud LL. Flumazenil versus placebo or no intervention for people with cirrhosis and hepatic encephalopathy.Cochrane Database Syst Rev. 2017;8(viii):CD002798. doi:ten.1002/14651858.CD002798.pub4

7. Hood SD, Norman A, Hince DA, et al. Benzodiazepine dependence and its treatment with low dose flumazenil.British Journal of Clinical Pharmacology. 2014;77(two):285-294. doi:10.1111/bcp.12023

8. U.South. National Library of Medicine. Flumazenil injection.

Additional Reading

• Bounds CG, Nelson VL. Benzodiazepines. In: StatPearls [Cyberspace]. Treasure Island (FL): StatPearls Publishing.

• Nutrient and Drug Administration. Romazicon (flumazenil) label.

• Sharbaf Shoar N, Saadabadi A. Flumazenil. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

By Ruth Jessen Hickman, MD
Ruth Jessen Hickman, Md, is a freelance medical and wellness author and published book author.

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