The two reversal agents, side by side, as their own monographs state them. Both monographs stress that a properly titrated sedative rarely needs reversing, and that a reversed patient must be watched for resedation.
| Agent | Reverses | Route | Onset | Peak | Duration | Adult dose (as stated) | Watch for |
|---|---|---|---|---|---|---|---|
| Naloxone (Narcan) | Opioids (narcotics) | IV (supplied for IV, IM and SC use) | 1–2 minutes | 5–15 minutes | 30–45 minutes | 0.04–2 mg titrated in small increments: 0.4 mg diluted to 10 mL (0.04 mg/mL), 1 mL at a time with 2–3 minutes between doses; 2 mg total for nursing administration | Resedation after the dose wears off; reversal of analgesia, hypertension, excitation and tachycardia with larger doses |
| Flumazenil (Romazicon) | Benzodiazepines | IV bolus or infusion | 1–2 minutes | 6–10 minutes (80% of maximum response within 3 minutes) | 45–90 minutes | 0.2 mg IV over 15 seconds to 1 minute; repeat at 1-minute intervals to a cumulative 1 mg, then call anesthesia if no response; infusion 30–60 mcg/min, no more than 3 mg/hour | Resedation for up to 120 minutes; seizures in patients physically dependent on benzodiazepines; the manufacturer does not recommend use under age 18 |
Every figure above is taken from the linked monograph on this site; a dash means the monograph does not state it. Verify all doses against the current package insert and your facility protocols before clinical use.
Naloxone (Narcan)
Flumazenil (Romazicon)
Educational reference for sedation providers, relocated from the previous version of this site — not a substitute for the current package insert, your facility protocols, or clinical judgment. Verify all doses against current references before clinical use.