Details
Stereochemistry | ACHIRAL |
Molecular Formula | C15H14FN3O3 |
Molecular Weight | 303.2889 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CCOC(=O)c1c2CN(C)C(=O)c3cc(ccc3-n2cn1)F
InChI
InChIKey=OFBIFZUFASYYRE-UHFFFAOYSA-N
InChI=1S/C15H14FN3O3/c1-3-22-15(21)13-12-7-18(2)14(20)10-6-9(16)4-5-11(10)19(12)8-17-13/h4-6,8H,3,7H2,1-2H3
DescriptionSources: http://www.drugbank.ca/drugs/DB01205Curator's Comment:: Description was created based on several sources, including
https://www.drugs.com/cdi/flumazenil.html
Sources: http://www.drugbank.ca/drugs/DB01205
Curator's Comment:: Description was created based on several sources, including
https://www.drugs.com/cdi/flumazenil.html
Fumazenil is an imidazobenzodiazepine derivative and a potent benzodiazepine receptor antagonist that competitively inhibits the activity at the benzodiazepine recognition site on the GABA/benzodiazepine receptor complex, thereby reversing the effects of benzodiazepine on the central nervous system. Fumazenil is used for the complete or partial reversal of the sedative effects of benzodiazepines in cases where general anesthesia has been induced and/or maintained with benzodiazepines, and where sedation has been produced with benzodiazepines for diagnostic and therapeutic procedures. Also for the management of benzodiazepine overdose as an adjunct for appropriate supportive and symptomatic measures. Flumazenil went off patent in 2008 so at present generic formulations of this drug are available.
CNS Activity
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL2093872 Sources: http://www.drugbank.ca/drugs/DB01205 |
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Target ID: CHEMBL1962 Sources: https://www.ncbi.nlm.nih.gov/pubmed/?term=18973287 |
3.3 nM [Ki] | ||
Target ID: CHEMBL2095190 Sources: https://www.ncbi.nlm.nih.gov/pubmed/10633039 |
148.0 nM [Ki] | ||
Target ID: P18507 Gene ID: 2566.0 Gene Symbol: GABRG2 Target Organism: Homo sapiens (Human) Sources: http://www.drugbank.ca/drugs/DB01205 |
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Target ID: CHEMBL3026 Sources: https://www.ncbi.nlm.nih.gov/pubmed/18973287 |
8.1 nM [Ki] | ||
Target ID: CHEMBL4956 Sources: https://www.ncbi.nlm.nih.gov/pubmed/18973287 |
5.7 nM [Ki] | ||
Target ID: CHEMBL2472 Sources: https://www.ncbi.nlm.nih.gov/pubmed/18973287 |
2.0 nM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Secondary | FLUMAZENIL Approved UseFlumazenil Injection, USP is indicated for the complete or partial reversal of the sedative effects of benzodiazepines in cases where general anesthesia has been induced and/or maintained with benzodiazepines, where sedation has been produced with benzodiazepines for diagnostic and therapeutic procedures, and for the management of benzodiazepine overdose. Launch Date1.09745281E12 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
6.98 ng/mL |
2.2 mg single, sublingual dose: 2.2 mg route of administration: Sublingual experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
45.9 ng/mL |
0.2 mg single, intravenous dose: 0.2 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
5.28 ng/mL |
2.2 mg single, sublingual dose: 2.2 mg route of administration: Sublingual experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
12 ng × h/mL |
2.2 mg single, sublingual dose: 2.2 mg route of administration: Sublingual experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
12.9 ng × h/mL |
0.2 mg single, intravenous dose: 0.2 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
9.1 ng × h/mL |
2.2 mg single, sublingual dose: 2.2 mg route of administration: Sublingual experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1.05 h |
2.2 mg single, sublingual dose: 2.2 mg route of administration: Sublingual experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
1.18 h |
0.2 mg single, intravenous dose: 0.2 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
1.12 h |
2.2 mg single, sublingual dose: 2.2 mg route of administration: Sublingual experiment type: SINGLE co-administered: |
FLUMAZENIL plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT |
Doses
Dose | Population | Adverse events |
---|---|---|
3 mg single, intravenous Highest studied dose Dose: 3 mg Route: intravenous Route: single Dose: 3 mg Sources: |
unhealthy, 32-62 n = 10 Health Status: unhealthy Condition: epilepsy Age Group: 32-62 Sex: M+F Population Size: 10 Sources: |
|
7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Other AEs: Injection site pain, Agitation... Other AEs: Injection site pain (10.3%) Sources: Agitation (8%) Anxiety (3.4%) Crying abnormal (3.4%) Headache (3.4%) Vomiting (3.4%) Tachycardia (3.4%) Dizziness (3.4%) Nausea (2.3%) Convulsions (1.1%) |
1 mg single, intravenous Recommended Dose: 1 mg Route: intravenous Route: single Dose: 1 mg Sources: |
unhealthy, adult n = 265 Health Status: unhealthy Condition: hepatic encephalopathy Age Group: adult Sex: M+F Population Size: 265 Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Convulsions | 1.1% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Injection site pain | 10.3% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Nausea | 2.3% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Anxiety | 3.4% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Crying abnormal | 3.4% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Dizziness | 3.4% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Headache | 3.4% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Tachycardia | 3.4% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Vomiting | 3.4% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
Agitation | 8% | 7.13 mg single, intravenous (mean) Recommended Dose: 7.13 mg Route: intravenous Route: single Dose: 7.13 mg Sources: |
unhealthy, 35.2 years (range: 17-75 years) n = 87 Health Status: unhealthy Condition: benzodiazepine overdose Age Group: 35.2 years (range: 17-75 years) Sex: M+F Population Size: 87 Sources: |
PubMed
Title | Date | PubMed |
---|---|---|
A controlled study of flumazenil-precipitated withdrawal in chronic low-dose benzodiazepine users. | 1999 Nov |
|
Flumazenil challenge in social phobia. | 2000 |
|
[Delayed postanoxic encephalopathy]. | 2000 Aug |
|
Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year. | 2001 |
|
Flumazenil use in an emergency department: a survey. | 2001 |
|
Different sensitivities to competitive inhibition of benzodiazepine receptor binding of 11C-iomazenil and 11C-flumazenil in rhesus monkey brain. | 2001 Apr |
|
Effects of diazepam and flumazenil on minimum alveolar concentrations for dogs anesthetized with isoflurane or a combination of isoflurane and fentanyl. | 2001 Apr |
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Neocortical abnormalities of [11C]-flumazenil PET in mesial temporal lobe epilepsy. | 2001 Apr 10 |
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Diazepam increases the hypothalamic-pituitary-adrenocortical (HPA) axis activity by a cyclic AMP-dependent mechanism. | 2001 Aug |
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The effects of benzodiazepines on human opioid receptor binding and function. | 2001 Aug |
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Delayed synaptic dysfunction of association cortices in carbon monoxide intoxication. | 2001 Dec |
|
Brain function in social anxiety disorder. | 2001 Dec |
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Involvement of benzodiazepine binding sites in an antiaggressive effect by 5-HT(1A) receptor activation in isolated mice. | 2001 Dec 7 |
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Asymmetrical localization of benzodiazepine receptors in the human auditory cortex. | 2001 Jan |
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A small dose of midazolam decreases the time to achieve hypnosis without delaying emergence during short-term propofol anesthesia. | 2001 Jun |
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Mice performance on the staircase test following acute ethanol administration. | 2001 Mar |
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Behavioral and pharmaco-toxicological study of Papaver rhoeas L. in mice. | 2001 Mar 3 |
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Modification of the effects of benzodiazepines on the exploratory behaviors of mice on a hole-board by diabetes. | 2001 May |
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Flumazenil's reversal of myoclonic-like movements associated with midazolam in term newborns. | 2001 May |
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Absolute quantification by positron emission tomography of the endogenous ligand. | 2001 May |
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Loss of the major GABA(A) receptor subtype in the brain is not lethal in mice. | 2001 May 15 |
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Behavioral effects of agents active at the gamma-aminobutyric acid receptor complex in the staircase paradigm. | 2001 May 18 |
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Neuroreceptor bindings and synaptic activity in visual system of monocularly enucleated rat. | 2001 May-Jun |
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Estimation of regional cerebral blood flow levels in ischemia using [(15)O]water of [(11)C]flumazenil PET without arterial input function . | 2001 May-Jun |
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The negative GABA(A) modulator methyl beta-carboline-3-carboxylate attenuates the behavioral effects of the positive GABA(A) modulators triazolam and pregnanolone in rhesus monkeys. | 2001 Nov |
|
Flumazenil improves cognitive and neuromotor emergence and attenuates shivering after halothane-, enflurane- and isoflurane-based anesthesia. | 2001 Nov |
|
Confluence of antianalgesic action of diverse agents through brain interleukin(1beta) in mice. | 2001 Nov |
|
[Functional imaging (PET and SPECT) in epilepsy]. | 2001 Nov 4 |
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Benzodiazepines in the intensive care unit. | 2001 Oct |
|
Biodistribution, binding specificity and metabolism of [18F]fluoroethylflumazenil in rodents. | 2001 Oct |
|
Potency of positive gamma-aminobutyric acid(A) modulators to substitute for a midazolam discriminative stimulus in untreated monkeys does not predict potency to attenuate a flumazenil discriminative stimulus in diazepam-treated monkeys. | 2001 Sep |
|
Binding and neuropharmacological profile of zaleplon, a novel nonbenzodiazepine sedative/hypnotic. | 2002 Jan 2 |
Patents
Sample Use Guides
In Vivo Use Guide
Sources: https://www.drugs.com/dosage/flumazenil.html
Usual Adult Dose for Reversal of Sedation
Initial dose: 0.2 mg IV one time over 15 seconds.
Repeated doses: 0.2 mg may be given every minute until the desired level of consciousness is achieved.
Maximum total dose 1 mg.
Most patients respond to 0.6 to 1 mg.
Route of Administration:
Intravenous
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/15531382
Exposure (48 h) of human embryonic kidney (HEK) 293 cells stably expressing recombinant alpha1beta2gamma2S GABAA receptors to flumazenil (1 or 5 uM) in the presence of GABA (1 uM) enhanced the maximum number (Bmax) of [3H]flunitrazepam binding sites without affecting their affinity (Kd).
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Classification Tree | Code System | Code | ||
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WHO-ATC |
V03AB25
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WHO-VATC |
QV03AB25
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NCI_THESAURUS |
C1012
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NDF-RT |
N0000175680
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5311
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4457
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SUB07693MIG
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3373
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M5436
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C47534
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78755-81-4
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4192
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1195
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FLUMAZENIL
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D005442
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CHEMBL407
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78755-81-4
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1273808
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DB01205
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40P7XK9392
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ACTIVE MOIETY
METABOLITE (PARENT)