• Do not confuse flumazenil with influenza virus vaccine.

• Ensure that patient has a patent airway before administration of flumazenil.

» Observe IV site frequently for redness or irritation. Administer through a free-flowing IV infusion into a large vein to minimize pain at the injection site.

» Optimal emergence should be undertaken slowly to decrease undesirable effects including confusion, agitation, emotional lability, and perceptual distortion.

» Institute seizure precautions. Seizures are more likely to occur in patients who are experiencing sedative/hypnotic withdrawal, patients who have recently received repeated doses of benzodiazepines, or those who have a previous history of seizure activity. Seizures may be treated with benzodiazepines, barbiturates, or phenytoin. Larger than normal doses of benzodiazepines may be required.

• Suspected Benzodiazepine Overdose: If no effects are seen after administration of flumazenil, consider other causes of decreased level of consciousness (alcohol, barbiturates, opioid analgesics).

• pH:
4.0.

• Direct IV:

Diluent: May be administered undiluted or diluted in syringe with D5W, 0.9% NaCl, or LR. Diluted solution should be discarded after 24 hr.
Concentration: Up to 0.1 mg/mL.

• Rate:
Administer each dose over 15–30 sec into free-flowing IV in a large vein. Do not exceed 0.2 mg/min in children or 0.5 mg/min in adults.