Flumazenil Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Reversal of Sedation

Initial dose: 0.2 mg IV one time over 15 seconds.
Repeated doses: 0.2 mg may be given every minute until the desired level of consciousness is achieved.
Maximum total dose 1 mg.
Most patients respond to 0.6 to 1 mg.
Resedation doses: 0.2 mg every minute to a total of 1 mg/dose and 3 mg/hour.

Usual Adult Dose for Benzodiazepine Overdose

Initial dose: 0.2 mg IV one time over 30 seconds.
Repeated doses: 0.5 mg may be given every minute.
Maximum total dose 3 mg. Patients responding partially at 3 mg may receive additional doses up to 5 mg.
Most patients respond to 1 to 3 mg.
Resedation doses: 0.5 mg every 20 minutes to a total of 1 mg/dose and 3 mg/hour.

Usual Pediatric Dose for Reversal of Sedation

IV:
Infants and Children:
Benzodiazepine reversal when used in conscious sedation or general anesthesia:
Initial dose: 0.01 mg/kg (maximum dose: 0.2 mg) given over 15 seconds; may repeat 0.01 mg/kg (maximum dose: 0.2 mg) after 45 seconds, and then every minute to a maximum total cumulative dose of 0.05 mg/kg or 1 mg, whichever is lower; usual total dose: 0.08 to 1 mg (mean: 0.65 mg)
Management of benzodiazepine overdose: Minimal information available; initial dose: 0.01 mg/kg (maximum dose: 0.2 mg) with repeat doses of 0.01 mg/kg (maximum dose: 0.2 mg) given every minute to a maximum total cumulative dose of 1 mg; as an alternative to repeat bolus doses, follow up continuous infusions of 0.005 to 0.01 mg/kg/hour have been used; further studies are needed.

Usual Pediatric Dose for Benzodiazepine Overdose

1 to 17 years:
Initial dose: 0.01 mg/kg IV over 15 seconds.
Repeat doses: 0.01 mg/kg given over 15 seconds; may repeat 0.01 mg/kg after 45 seconds, then every minute to a maximum total cumulative dose of 0.05 mg/kg.

Continuous IV infusion: 0.005 to 0.01 mg/kg/hr was used in a premature neonate (gestational age: 32 weeks) exposed to high doses of diazepam intrapartum.
Myoclonus, benzodiazepine induced: IV: 0.078 mg/kg once was effective in a single full-term neonate who was receiving continuous infusion midazolam.

Renal Dose Adjustments

No adjustments recommended

Liver Dose Adjustments

In general, a prolongation of flumazenil effect should be anticipated in patients with liver disease and particularly cautious dosing (using the smallest effective doses with the longest effective interval) under close medical observation is recommended for this patient.

Dialysis

No adjustments recommended

Other Comments

General supportive care (including control and maintenance of the airway) is indicated before and during flumazenil therapy. No more than 3 mg should be administered in any one hour.

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