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Flumazenil Disease Interactions

There are 4 disease interactions with flumazenil.

Major

Flumazenil (applies to flumazenil) seizures

Major Potential Hazard, Moderate plausibility. Applicable conditions: Head Injury

Flumazenil has been associated with seizure activity, particularly in patients receiving repeated doses of benzodiazepines for long term sedation, acute overdose involving concurrent cyclic antidepressants, or head injury where it may alter cerebral blood flow in patients receiving benzodiazepines. Therapy with flumazenil should be administered cautiously in patients with a history of or predisposition to seizures.

References (5)
  1. Marchant B, Wray R, Leach A, Nama M (1989) "Flumazenil causing convulsions and ventricular tachycardia." BMJ, 299, p. 860
  2. Mordel A, Winkler E, Almog S, Tirosh M, Ezra D (1992) "Seizures after flumazenil administration in a case of combined benzodiazepine and tricyclic antidepressant overdose." Crit Care Med, 20, p. 1733-4
  3. Thomas P, Lebrun C, Chatel M (1993) "De novo absence status epilepticus as a benzodiazepine withdrawal syndrome." Epilepsia, 34, p. 355-8
  4. (2001) "Product Information. Romazicon (flumazenil)." Roche Laboratories
  5. Chern TL, Kwan A (1996) "Flumazenil-induced seizure accompanying benzodiazepine and baclofen intoxication." Am J Emerg Med, 14, p. 231-2
Moderate

Flumazenil (applies to flumazenil) alcoholism

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Drug Abuse/Dependence

Flumazenil should be used with caution in patients with alcoholism and other drug dependencies due to the increased frequency of benzodiazepine tolerance and dependence observed in these patient populations.

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

Flumazenil (applies to flumazenil) hepatic dysfunction

Moderate Potential Hazard, High plausibility. Applicable conditions: Liver Disease, Congestive Heart Failure

Flumazenil is a highly extracted drug, dependent on blood flow, and primarily metabolized by the liver. Hepatic clearance is decreased 40% to 60 % in patients with moderate hepatic dysfunction and 75% in patients with severe hepatic dysfunction. Care should be exercised as the metabolic and therapeutic activity of flumazenil may be altered in patients with compromised hepatic function or conditions that decrease systemic blood flow. Following the initial dose, subsequent doses or the frequency of administration should be reduced.

References (6)
  1. Klotz U (1988) "Drug interactions and clinical pharmacokinetics of flumazenil." Eur J Anaesthesiol Suppl, 2, p. 103-8
  2. Janssen U, Walker S, Maier K, von Gaisberg U, Klotz U (1989) "Flumazenil disposition and elimination in cirrhosis." Clin Pharmacol Ther, 46, p. 317-23
  3. Pomier-Layrargues G, Giguere JF, Lavoie J, Willems B, Butterworth RF (1989) "Pharmacokinetics of benzodiazepine antagonist Ro 15-1788 in cirrhotic patients with moderate or severe liver dysfunction." Hepatology, 10, p. 969-72
  4. Roncari G, Ziegler WH, Guentert TW (1986) "Pharmacokinetics of the new benzodiazepine antagonist Ro 15-1788 in man following intravenous and oral administration." Br J Clin Pharmacol, 22, p. 421-8
  5. van der Rijt CC, Drost RH, Schalm SW, Schramel M (1991) "Pharmacokinetics of flumazenil in fulminant hepatic failure." Eur J Clin Pharmacol, 41, p. 501
  6. (2001) "Product Information. Romazicon (flumazenil)." Roche Laboratories
Moderate

Flumazenil (applies to flumazenil) psychoses

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

Panic attacks have been induced by flumazenil in patients with a history of panic attacks. Emotional lability, including crying, depersonalization, euphoria, depression, dysphoria and paranoia have also been reported. Therapy with flumazenil should be administered cautiously in patients with or predisposed to psychosis, particularly panic attacks.

References (4)
  1. Seebach J, Jost R (1992) "Flumazenil-induced psychotic disorder in hepatic encephalopathy." Lancet, 339, p. 488-9
  2. (1992) "Flumazenil." Med Lett Drugs Ther, 34, p. 66-8
  3. Griffiths RR, Evans SM, Guarino JJ, Roache JD, Furman WR, Liebson I, Schwam EM (1993) "Intravenous flumazenil following acute and repeated exposure to lorazepam in healthy volunteers: antagonism and precipitated withdrawal." J Pharmacol Exp Ther, 265, p. 1163-74
  4. (2001) "Product Information. Romazicon (flumazenil)." Roche Laboratories

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Flumazenil drug interactions

There are 29 drug interactions with flumazenil.

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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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