What is the maximum adult dose per hour for flumazenil?

• A. 3 mg/hour
• B. 1 mg/hour
• C. 5 mg/hour
• D. 0.5 mg/hour

Answer: (A)

Flumazenil is a competitive antagonist at the benzodiazepine site on the GABA-A receptor, used to reverse benzodiazepine-induced CNS depression. When reversal is needed over a prolonged period—such as with long-acting benzodiazepines or persistent sedation—an infusion may be used, but the rate is kept low to avoid precipitating withdrawal, seizures, or re-sedation as the benzodiazepine effect wanes. The maximum recommended infusion rate in adults is 3 mg per hour. Rates higher than this increase the risk of adverse effects, while lower rates might not adequately counteract ongoing benzodiazepine effects. In practice, bolus doses are more common and continuous infusion is avoided unless absolutely necessary.