Flumazenil

CLINICAL USE

Reversal of sedative effects of benzodiazepines in anaesthetic, intensive care, and diagnostic procedures

DOSE IN NORMAL RENAL FUNCTION

Initially 200 micrograms over 15 seconds, then 100 micrograms at 60 second intervals if required; usual dose range 300–600 micrograms; maximum dose 1 mg, or 2 mg in intensive care situationsIf drowsiness recurs, an

IV infusion

of 100–400 micrograms per hour may be given

PHARMACOKINETICS

Molecular weight :303.3

%Protein binding :50

%Excreted unchanged in urine : <0.1

Volume of distribution (L/kg) :0.6–1.1

half-life – normal/ESRD (hrs) :0.7–1.3/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in normal renal function

HD :Unknown dialysability. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

–

Route

IV injection,

IV infusion

Rate of Administration

See ‘Dose in normal renal function’

Comments

Infusion: suitable diluents include sodium chloride 0.9%, sodium chloride 0.45% and glucose 5%

OTHER INFORMATION

The half-life of flumazenil is shorter than those of diazepam and midazolam – patients should be closely monitored to avoid the risk of them becoming re-sedated

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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