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Drug Interactions between flumazenil and temazepam

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

temazepam flumazenil

Applies to: temazepam and flumazenil

GENERALLY AVOID: The administration of flumazenil can result in convulsions in patients who have been receiving long-term treatment with benzodiazepines for epilepsy or sedation or who have recently received repeated doses of parenteral benzodiazepines. The mechanism is abrupt reversal of the benzodiazepine's anticonvulsive effects. In addition, withdrawal seizures may occur in patients who are physically dependent on benzodiazepines.

MANAGEMENT: The use of flumazenil is not recommended in patients with epilepsy who have been receiving long-term treatment with benzodiazepines. In addition, flumazenil is contraindicated in patients who have received a benzodiazepine to control potentially life-threatening conditions such as status epilepticus or increased intracranial pressure. Extreme caution, dose individualization, and close monitoring is recommended for other patients. Clinicians should be prepared to manage convulsions. Most seizures have been successfully managed with benzodiazepines, phenytoin, or barbiturates.

References (1)
  1. (2001) "Product Information. Romazicon (flumazenil)." Roche Laboratories

Drug and food interactions

Moderate

temazepam food

Applies to: temazepam

GENERALLY AVOID: Acute ethanol ingestion may potentiate the CNS effects of many benzodiazepines. Tolerance may develop with chronic ethanol use. The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition. Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.

MANAGEMENT: Patients should be advised to avoid alcohol during benzodiazepine therapy.

References (7)
  1. MacLeod SM, Giles HG, Patzalek G, Thiessen JJ, Sellers EM (1977) "Diazepam actions and plasma concentrations following ethanol ingestion." Eur J Clin Pharmacol, 11, p. 345-9
  2. Whiting B, Lawrence JR, Skellern GG, Meier J (1979) "Effect of acute alcohol intoxication on the metabolism and plasma kinetics of chlordiazepoxide." Br J Clin Pharmacol, 7, p. 95-100
  3. Divoll M, Greenblatt DJ, Lacasse Y, Shader RI (1981) "Benzodiazepine overdosage: plasma concentrations and clinical outcome." Psychopharmacology (Berl), 73, p. 381-3
  4. Juhl RP, Van Thiel DH, Dittert LW, Smith RB (1984) "Alprazolam pharmacokinetics in alcoholic liver disease." J Clin Pharmacol, 24, p. 113-9
  5. Ochs HR, Greenblatt DJ, Arendt RM, Hubbel W, Shader RI (1984) "Pharmacokinetic noninteraction of triazolam and ethanol." J Clin Psychopharmacol, 4, p. 106-7
  6. Staak M, Raff G, Nusser W (1979) "Pharmacopsychological investigations concerning the combined effects of dipotassium clorazepate and ethanol." Int J Clin Pharmacol Biopharm, 17, p. 205-12
  7. Nichols JM, Martin F, Kirkby KC (1993) "A comparison of the effect of lorazepam on memory in heavy and low social drinkers." Psychopharmacology (Berl), 112, p. 475-82

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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