A Poison Center's Ten-year Experience with Flumazenil Administration to Acutely Poisoned Adults

Safety and Efficacy of Flumazenil for Reversal of Iatrogenic Benzodiazepine-Associated Delirium Toxicity During Treatment of Alcohol Withdrawal, a Retrospective Review at One Center

“…Complication rates after flumazenil administration have been reported anywhere from 0.1 to 23.4 % [13][14][15][16]. Adverse events such as anxiety, agitation, seizures, and arrhythmias have been described [12][13][14][17][18][19].…”

“…Adverse events such as anxiety, agitation, seizures, and arrhythmias have been described [12][13][14][17][18][19]. While most of the existing literature points toward the safety of flumazenil use in cases of acute benzodiazepine overdose and postoperative sedation, there has been only one published study using flumazenil for the treatment of a complication of AWS, benzodiazepine delirium.…”

Acute encephalopathy in a 2‐year‐old pot‐bellied pig following accidental intoxication with clonazepam

“…One potential contraindication to flumazenil administration is in some instances of cointoxication . Administration of flumazenil in patients with BZP and TCA cointoxication can induce seizures, thought to be a result of the proconvulsant effects of TCAs .…”

“…One potential contraindication to flumazenil administration is in some instances of cointoxication . Administration of flumazenil in patients with BZP and TCA cointoxication can induce seizures, thought to be a result of the proconvulsant effects of TCAs . In a placebo‐controlled study in anesthetized dogs that were administered overdoses of midazolam and amitriptyline, midazolam provided a protective effect against seizures resulting from amitriptyline toxicity.…”

Mechanisms of Action and Persistent Neuroplasticity by Drugs of Abuse

“…It is available as intravenous injection and its half-life is short (about 1 hour) in humans (Klotz et al, 1984;Roncari et al, 1993). It is primarily used in BZ intoxications or in the treatment and diagnosis of drug intoxications (Hoffman and Warren, 1993;Kreshak et al, 2012). As a competitive BZ antagonist, its acute actions can be well understood as counteracting the effects of agonists.…”