Pricing
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All price changes →Indications & Uses
Anexate (flumazenil) is indicated for reversal of the centrally sedative effects of benzodiazepines. So it is used in anaesthesia and intensive care for the following purposes. In anaesthesia, it is used for termination of general anaesthesia that was induced and maintained with benzodiazepines in inpatients. It is also used to reverse benzodiazepine sedation in short diagnostic and therapeutic procedures, in both inpatients and outpatients, and to reverse paradoxical reactions due to benzodiazepines. In intensive care and in the management of unconsciousness of unknown origin, Anexate is used for the diagnosis and/or management of benzodiazepine overdose, whether it happened through self-poisoning or by accident. It can also serve as a diagnostic measure when a person is unconscious and the cause isn't known, to tell apart involvement of benzodiazepines, other medicines or drugs, or brain damage. Anexate may also be used for specific reversal of the central effects of benzodiazepines in drug or medicine overdose. The aim is to bring back spontaneous respiration and consciousness, so that intubation becomes unnecessary or extubation becomes possible.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Flumazenil is recommended for intravenous (IV) use only and should be administered by an anaesthesiologist or an experienced physician.
In anaesthesia: The recommended initial dose of Flumazenil is 0.2 mg, administered IV over 15 seconds. If the desired degree of consciousness is not obtained within 60 seconds, a second dose of 0.1 mg can be injected. This may be repeated at 60 second intervals where necessary, up to a total dose of 1 mg. The usual dose is 0.3 to 0.6 mg, but individual requirements may vary considerably, depending on the dose and duration of effect of the benzodiazepine administered and on patient characteristics.
In intensive care and in the management of unconsciousness of unknown origin: The recommended initial dose of Flumazenil is 0.3 mg IV. If the desired level of consciousness is not obtained within 60 seconds, Flumazenil may be injected repeatedly until the patient awakes, up to a total dose of 2 mg. If drowsiness recurs, Flumazenil may be given as one or more bolus IV doses as above, or as an IV infusion of 0.1 to 0.4 mg per hour. The rate of infusion should be adjusted individually to the desired level of arousal. If repeated doses of Flumazenil do not bring a significant improvement in consciousness or respiratory function, a non benzodiazepine cause must be assumed. In the intensive care unit, in patients treated with high doses of benzodiazepines and/or for long periods, individually titrated injections of Flumazenil, given slowly, should not produce withdrawal symptoms. If unexpected symptoms occur, diazepam or midazolam can be carefully titrated intravenously according to the patient's response.
Children above 1 year of age: For reversing conscious sedation induced with benzodiazepines in children above one year of age, the recommended initial dose is 0.01 mg/kg (up to 0.2 mg), administered IV over 15 seconds. If the desired level of consciousness is not obtained after an additional 45 seconds, further injections of 0.01 mg/kg (up to 0.2 mg) can be given and repeated at 60 second intervals where necessary, up to a maximum of four additional times, to a maximum total dose of 0.05 mg/kg or 1 mg, whichever is lower. The dose should be individualised based on the patient's response. No data are available on the safety and efficacy of repeated administration of Flumazenil to children for re sedation.
Side Effects
Resurge is well tolerated in both adults and children. In adults, it is still well tolerated even at doses higher than those recommended. Allergic reactions, including anaphylaxis, have been seen. After a rapid injection of Resurge, people have only occasionally reported feeling anxious, having palpitations or feeling afraid. These effects usually pass without needing any special treatment. Seizures have been reported in people who already have epilepsy or severe liver impairment. They are more likely after long-term use of benzodiazepines, or when a person has overdosed on a mix of substances. In a mixed-substance overdose, especially one involving cyclic antidepressants, toxic effects such as convulsions and irregular heartbeats can appear once the benzodiazepine effects are reversed by Resurge. Withdrawal symptoms may follow a rapid injection of Resurge in people who have been exposed to benzodiazepines over a long period, if they stopped taking them at any point in the weeks before Resurge was given. Resurge has also been reported to bring on panic attacks in people with a history of panic disorder.
Cautions & Contraindications
Warnings & Precautions
Particular caution is necessary when using Resurge in cases of mixed substance overdose, since the toxic effects (such as convulsions and irregular heart rhythms) of other medicines taken in overdose, especially cyclic antidepressants, may emerge once Resurge reverses the effects of the benzodiazepine. The use of Resurge is not recommended in epileptic patients who have been receiving benzodiazepine treatment for a prolonged period. Although Resurge exerts a slight anticonvulsant effect of its own, its abrupt suppression of the protective effect of a benzodiazepine agonist can bring on convulsions in epileptic patients. Patients who have received Resurge for the reversal of benzodiazepine effects should be monitored for resedation, respiratory depression or other residual benzodiazepine effects for a suitable period, based on the dose and duration of effect of the benzodiazepine used. Since patients with underlying liver impairment may experience delayed benzodiazepine effects, a longer observation period may be needed. When Resurge is used together with neuromuscular blocking agents, it should not be injected until the effects of the neuromuscular block have been fully reversed. Resurge should be used with caution in patients with head injury, as it may be capable of triggering convulsions or altering cerebral blood flow in patients receiving benzodiazepines. Rapid injection of Resurge should be avoided in patients who have had high dose and/or long term exposure to benzodiazepines ending at any time within the preceding weeks, as it may bring on withdrawal symptoms, including agitation, anxiety, emotional instability, as well as mild confusion and sensory distortions. Resurge is not recommended either as a treatment for benzodiazepine dependence or for managing prolonged benzodiazepine withdrawal syndromes. Resurge should be used with caution for reversing conscious sedation in children below the age of one year, for managing overdose in children, for resuscitating newborns, and for reversing the sedative effects of benzodiazepines used to induce general anaesthesia in children, since experience in these situations is limited.
Contraindications
Flumazenil should not be used in anyone known to be hypersensitive to it. It is also not given to reverse a benzodiazepine that was being used to control a potentially life-threatening condition, such as raised pressure within the skull or status epilepticus.
Pregnancy & Breastfeeding
Pregnancy: Although high-dose studies of Flumazenil in animals and in-vitro systems have not pointed to mutagenic or teratogenic effects, or to any impairment of fertility, its safety in human pregnancy is not yet established. For this reason, it should only be used in pregnancy if the potential benefit is judged to outweigh any possible risk to the unborn child.
Breastfeeding: Flumazenil given parenterally for emergency reversal is not contraindicated during breastfeeding. High-dose animal studies have likewise shown no evidence that it impairs fertility.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Storage
Store Flumazenil below 30°C and keep it away from light and moisture. Keep it out of the reach of children.
Drug Interactions
Common questions about Resurge 0.5 mg/5 ml
What is Resurge 0.5 mg/5 ml IV Injection?
Resurge 0.5 mg/5 ml IV Injection is a medicine that contains Flumazenil. It is made by Incepta Pharmaceuticals Ltd.
What is Resurge used for?
Anexate (flumazenil) is indicated for reversal of the centrally sedative effects of benzodiazepines. So it is used in anaesthesia and intensive care for the following purposes.
What are the side effects of Resurge?
Resurge is well tolerated in both adults and children. In adults, it is still well tolerated even at doses higher than those recommended.
Can I take Resurge during pregnancy or while breastfeeding?
Pregnancy: Although high-dose studies of Flumazenil in animals and in-vitro systems have not pointed to mutagenic or teratogenic effects, or to any impairment of fertility, its safety in human pregnancy is not yet established. For this reason, it should only be used in pregnancy if the potential benefit is judged to outweigh any possible risk to the unborn child. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Resurge?
Store Flumazenil below 30°C and keep it away from light and moisture. Keep it out of the reach of children.
Can I take other medicines with Resurge?
Some medicines can interact with Flumazenil, for example: Zopiclone, Ethanol 70%. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Resurge?
Resurge is a prescription (Rx) medicine. Take it as your doctor advises.