Sunday, June 29, 2025

Flumazenil use in non-benzodiazepine overdose

Q: Flumazenil can be an effective antidote for which other drugs besides benzodiazepines?


Answer: Flumazenil is traditionally used as an antidote in patients with benzodiazepine overdose, but it is effective in overdoses of non-benzodiazepine sleep enhancers, namely zolpidem (Ambien) and zaleplon (Sonata) -popularly known as "Z" drugs.

Flumazenil reverses the effects of benzodiazepines by competitive inhibition at the benzodiazepine binding site on the GABA-a receptor.

Additionally, it has been used in the treatment of hepatic encephalopathy.


#toxicity
#pharmacology


References:

1. Patat A, Naef MM, van Gessel E, Forster A, Dubruc C, Rosenzweig P. Flumazenil antagonizes the central effects of zolpidem, an imidazopyridine hypnotic. Clin Pharmacol Ther. 1994 Oct;56(4):430-6. doi: 10.1038/clpt.1994.157. PMID: 7955804.

2. An H, Godwin J. Flumazenil in benzodiazepine overdose. CMAJ. 2016 Dec 6;188(17-18):E537. doi: 10.1503/cmaj.160357. Epub 2016 Nov 14. PMID: 27920113; PMCID: PMC5135539.

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