![]() Flumazenil is contraindicated in the presence of serious concurrent cyclic antidepressant overdose or poisoning as manifested by motor abnormalities (twitching, rigidity, focal seizure), dysrhythmia (wide QRS, ventricular dysrhythmia, heart block), anticholinergic signs and symptoms, and cardiovascular collapse at presentation. Possible risk factors for seizures include: concurrent major sedative-hypnotic drug withdrawal, recent therapy with repeated doses of parenteral benzodiazepines, and myoclonic jerking or seizure activity prior to flumazenil administration in overdose cases. It should be used only by practitioners prepared to manage such complications should they occur. Use flumazenil with caution in patients with head trauma as it may be capable of precipitating convulsions or altering cerebral blood flow in patients receiving benzodiazepines. Flumazenil is contraindicated in patients who have received a benzodiazepine for the control of life-threatening conditions such as the control of increased intracranial pressure and status epilepticus. Use of flumazenil can precipitate signs of benzodiazepine withdrawal, which may precipitate seizures. Seizures are most frequent in patients receiving long-term benzodiazepine therapy (benzodiazepine dependence). Alcoholism, benzodiazepine dependence, head trauma, increased intracranial pressure, overdose, seizure disorder, seizures, status epilepticus, substance abuseįlumazenil therapy has been associated with seizures. ![]()
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