Presentation
0.5mg/5mL ampoule
Role
Management of coma and respiratory depression that occur as a result of benzodiazepine, zopiclone or zolpidem toxicity, where good supportive care is unavailable or not expected to be adequate. Specific examples include; patients where intubation is thought to be inappropriate (eg elderly, frail, severe respiratory disease) or for management in facilities where provision of advanced airway support (eg intubation and ventilation) is not possible.
Dose
0.1-0.2mg (child 5-10micrograms/kg) IV q5min aiming for rousing to voice and unobstructed airway.
Stocking recommendations
| Tertiary centre | Regional centre | Rural centre | Remote centre |
|---|---|---|---|
| 5 ampoules | 5 ampoules | 5 ampoules | 0-5 ampoules |
Rationale
Most benzodiazepine ingestions can be managed effectively with good supportive care. There is a limited role for flumazenil following poisonings. Flumazenil is commonly available to reverse benzodiazepines used in anaesthesia.
Precautions
- Use of flumazenil in patients who are benzodiazepine dependant should be avoided as it may precipitate seizures.
- After an initial response, recurrence of toxicity is common requiring repeated doses. Patients should be monitored in an appropriate environment.
Disclaimer
Fact sheet developed by Queensland Poisons Information Centre.
This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.