Liverpool Hospital Emergency Department
Indications: Competitive antagonist at BDZ receptors. Duration of action 45-60 minutes therefore BDZ half-life exceeds this.
- Generally, NOT recommended in acute benzodiazepine overdose as it may precipitate seizures
- Benzodiazepine overdose is rarely severe enough to require significant intervention and toxicity is mild
It can be considered in benzodiazepine naïve patients who have been exposed to a toxic dose – for example paediatric patients with accidental ingestion or to reverse iatrogenic procedural sedation.
- IV vials 500mcg/5mL
Dosage and Administration:
- It should only be given in a critical care setting
- Adult: 1mL to 2mL (0.1mg to 0.2mg) IV Bolus every 60 seconds repeated till clinical effect (Maximum 2mg cumulative, if no clinical effect to consider other causes)
- Children: 5mcg/Kg IV Bolus every 60 seconds repeated till clinical effect. (Maximum 8 Doses)
- Dilute 25mL (5 Ampoules = 2.5mg) in 25mL of 0.9% Sodium Chloride to make a 2.5mg/50mL syringe. (50mcg/mL)
- Start at 0.1 – 0.5mg/hour titrated to effect.
- Benzodiazepine withdrawal syndrome: agitation / tachycardia / seizures o Seizures
- Avoid in seizure disorder / ingestion of proconvulsant drugs / benzodiazepine dependence / suspicion of TCA overdose