FLUMAZENIL

Half-life: 8-20 minutes Clinically important, potentially hazardous interactions with: aldesleukin,

cimetidine, metronidazole

Reactions

Skin Acral erythema

(1995): Esteve E+, Ann Med Interne Paris (French) 146, 192 (1992): Doll DC+, Semin Oncol 19(5), 580 (1989): Vukelja SJ+, Ann Intern Med 111, 688 Actinic keratoses (sic) (1999): Nabai H+, Cutis 64, 43 (1987): Johnson TM+, J Am Acad Dermatol 17(2 Pt 1), 192 (1969): Omura EF+, JAMA 208, 150 (1962): Falkson G+, Br J Dermatol 74, 229 Angioedema Bullous eruption (1970): Bart BJ+, Arch Dermatol 102, 457 Dermatitis (sic) (>10%) (1999): Sanchez-Perez J+, Contact Dermatitis 41, 106 (1997): Anderson LL+, J Am Acad Dermatol 36, 478 (1996): Nadal C+, Contact Dermatitis 35, 124 (systemic) (1977): Goette DK+, Arch Dermatol 113, 1058 Eczema (sic) (1977): Bernstein T, New Engl J Med 297, 337 Edema of foot (1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford,

193 (passim) Erythema (1980): Hrushesky WJ, Cutis 26, 181 (1962): Falkson G+, Br J Dermatol 74, 229 Erythema multiforme (1980): Ueki H+, Hautarzt (German) 31, 207 Erythematous eruption, linear serpentine (sic) (1998): Pujol RM+, J Am Acad Dermatol 39, 839 Exanthems (1-10%) (1994): Leo S+, J Chemother 6, 423 (1994): Sollitto RB+, Arch Dermatol 130, 1194 (sun-exposed areas) Fissures Folliculitis (forehead) (2001): Schmid-Wendtner M-H+, Lancet 358, 1575 (passim) Hand-foot syndrome (2002): Cure H+, J Clin Oncol 20(5), 1175 (38%)

(2001): Elasmar SA+, Jpn J Clin Oncol 31(4), 172 (passim) (1997): Chiara S+, Eur J Cancer 33, 967 (1997): lurio A+, Acta Oncol 36, 653 (1997): Thaler D, Monona, WI (from internet) (observation) (1995): Banfield GK+, J R Soc Med 88, 356 (1994): Leo S+, J Chemother 6, 423 (1993): Beard JS+, J Am Acad Dermatol 29, 325 (1991): Jorda E+, Int J Dermatol 30, 653 (1989): Curran CF+, Ann Intern Med 111, 858 (1989): Vukelja SJ+, Ann Intern Med 111, 688 (1988): Guillaume J-C+, Ann Dermatol Venereol (French) 115, 1167 (1987): Molina R+, Proc Am Soc Clin Oncol 4, 92 (1985): Atkins JN, Ann Intern Med 102, 419 (1985): Feldman LD+, JAMA 254, 3479 (1984): Lokich JJ+, Ann Intern Med 101, 798 Infections (2002): Bonneterre J+, Br J Cancer 87(11), 1210 (7%) (with vinorelbine) Keratoderma (palms) (2001): Schmid-Wendtner M-H+, Lancet 358, 1575 (passim) Keratoses (2001): Kurzman MA, Staten Island, NY (from Internet) (observation) (2001): Lamberts RJ, Grand Rapids, MI (from Internet) (observation) (inflammation) Necrosis (1980): Yaffee HS+, Cutis 25, 649 (“ecdysis”) Palmar-plantar pigmentation (2001): Schmid-Wendtner M-H+, Lancet 358, 1575 (passim) Photosensitivity (<1%) (1999): von Moos R+, Schweiz Med Wochenschr (German) 129, 52 (1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford,

193 (passim) (1962): Falkson G+, Br J Dermatol 74, 229 Phototoxicity Pigmentation (<1%) (1997): Miller BH+, J Am Acad Dermatol 36, 72 (1995): Allen BJ+, Int J Dermatol 34, 219 (reticulate) (1994): Leo S+, J Chemother 6, 423 (1991): Vukelja SJ+, J Am Acad Dermatol 25, 905 (serpentine) (1980): Hrushesky WJ, Cutis 26, 181 (sun-exposed areas) (1977): Goette DK+, Arch Dermatol 113, 1058 (1962): Falkson G+, Br J Dermatol 74, 229 Pruritus Psoriasis (2002): Wetzig T+, Br J Dermatol 147(4), 824 Radiation recall (1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford,

193 (passim) Reactivation phenomenon (sic) (1997): Anderson LL+, J Am Acad Dermatol 36, 478 (1993): Prussick R+, Arch Dermatol 129, 644 Recall reaction (2003): Kirkup ME+, Dermatology 206(2), 175 Seborrheic dermatitis (1962): Falkson G+, Br J Dermatol 74, 229 Side effects (sic) (2002): Moazzam N+, J Clin Oncol 20(13), 3032 Systemic lupus erythematosus (2002): Moazzam N+, J Clin Oncol 20(13), 3032 Urticaria Xerosis (1-10%)

Hair Hair-alopecia (>10%)

(2003): Saini A+, Br J Cancer 88(12), 1859 (2002): Sloan JA+, J Clin Oncol 20(6), 1491 (2001): Madnani N, Mumbai, India (from Internet) (observation) (1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford,

193 (passim) (1962): Falkson G+, Br J Dermatol 74, 229

Nails Nails-onycholysis

Nails-pigmentation (<1%) (2001): Schmid-Wendtner M-H+, Lancet 358, 1575 (passim) (1962): Falkson G+, Br J Dermatol 74, 229

Other Anaphylactoid reactions

(1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford, 193 (passim)

Death (2003): van Kuilenburg AB+, Ann Oncol 14(2), 341 Dysgeusia Ectropion (1997): Lewis JE, Int J Dermatol 36, 79 (1994): Hecker D+, Cutis 53, 137 Injection-site burning (1998): Kraus S+, J Am Acad Dermatol 38, 438 (1997): Miller BH+, J Am Acad Dermatol 36, 72 Injection-site desquamation (1998): Kraus S+, J Am Acad Dermatol 38,438 (1997): Miller BH+, J Am Acad Dermatol 36, 72

(1997): Swinehart JM+, Arch Dermatol 133, 67 (1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford,

193 (passim) Injection-site edema (1997): Miller BH+, J Am Acad Dermatol 36, 72 (1997): Swinehart JM+, Arch Dermatol 133, 67 (1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford,

193 (passim) Injection-site erythema (1998): Kraus S+, J Am Acad Dermatol 38, 438 (1997): Miller BH+, J Am Acad Dermatol 36, 72 (1997): Swinehart JM+, Arch Dermatol 133, 67 (1992): Breathnach SM+, Adverse Drug Reactions and the Skin Blackwell, Oxford,

193 (passim) Injection-site necrosis (1998): Kraus S+, J Am Acad Dermatol 38, 438 (1997): Swinehart JM+, Arch Dermatol 133, 67 Injection-site pain (1998): Kraus S+, J Am Acad Dermatol 38, 438 (1997): Swinehart JM+, Arch Dermatol 133, 67 Injection-site pigmentation (2001): Schmid-Wendtner M-H+, Lancet 358, 1575 (passim) Injection-site ulceration (1997): Miller BH+, J Am Acad Dermatol 36, 72 (1997): Swinehart JM+, Arch Dermatol 133, 67 Mucositis (1-10%) (2003): Chen JY+, Ai Zheng 22(4), 418 (2003): Nottage M+, Support Care Cancer 11(1), 41 (79%) (2002): Cure H+, J Clin Oncol 20(5), 1175 (26%) (2001): Hejna M+, Eur J Cancer 37(16), 1994 Oral ulceration (2002): Xu D+, Zhonghua Zhong Liu Za Zhi 24(1), 93 (with leucovorin) Paresthesias (<1%) Phlebitis (2002): Xu D+, Zhonghua Zhong Liu Za Zhi 24(1), 93 (with leucovorin) Stomatitis (>10%) (2003): Rossi A+, Oncology 64(4), 353 (2003): Saini A+, Br J Cancer 88(12), 1859 (2003): Tebbutt NC+, Br J Cancer 88(10), 1510 (2002): Bonneterre J+, Br J Cancer 87(11), 1210 (40%) (with vinorelbine) (2002): Ito A+, Gan To Kagaku Ryoho 29(4), 563 (2002): McCollum AD+, J Natl Cancer Inst 94(15), 1160 (2002): Sloan JA+, J Clin Oncol 20(6), 1491 (2002): Ueno H+, Cancer Chemother Pharmacol 49(2), 155 Tongue pigmentation

(2001): Schmid-Wendtner M-H+, Lancet 358, 1575 (passim)

Trade names: Prozac (Dista) (Lilly); Sarafem (Dermik) Other common trade names: Adofen; Apo-Fluoxetine; Dom-Fluoxetine; Fluctin;

Fluctine; Fludac; Fluoxac; Fluoxeren; Fluxil; Fontex Indications: Depression, obsessive-compulsive disorder Category: Antidepressant; Selective serotonin reuptake inhibitor (SSRI) Half-life: 2-3 days Clinically important, potentially hazardous interactions with: alprazolam,

amphetamines, clarithromycin, clozapine, desipramine, dextroamphetamine, diethylpropion, erythromycin, haloperidol, imipramine, isocarboxazid, linezolid, lithium, MAO inhibitors, mazindol, meperidine, methamphetamine, midazolam, moclobemide, nortriptyline, phendimetrazine, phenelzine, phentermine, phenylpropanolamine, phenytoin, pimozide, pseudoephedrine, selegiline, serotonin agonists, sibutramine, St John’s wort, sumatriptan, sympathomimetics, tramadol, tranylcypromine, trazodone, tricyclic antidepressants, troleandomycin, tryptophan

Reactions

Skin Acne (<1%)

Allergic reactions (sic) (1998): Beauquier B+, Encephale (French) 24, 62 Angioedema (1991): Olfson M+, J Nerv Mental Dis 179, 504 Bruising (1996): Pai VB+, Ann Pharmacother 30, 786 Bullous eruption (<1%) Candidiasis Cellulitis Dermatitis (<1%) Diaphoresis (8.4%) (1985): Wernicke JF, J Clin Psychiatry 46, 59 Eczema (sic) (<1%) Erythema multiforme (1985): Wernicke JF, J Clin Psychiatry 46, 59 Erythema nodosum (<1%) Exanthems (4%) (1993): Gupta MA+, Cutis 51, 386 (3%) (passim)

(1993): Gupta RK+, Med J Aust 158, 722 (1993): Litt JZ, Beachwood, OH (personal case) (observation) (1991): Olfson M+, J Nerv Mental Dis 159, 504 (1989): Miller LG+, Am J Psychiatry 146, 1616 (1988): Cooper GL, Br J Psychiatry 153, 77 (1985): Wernicke JF, J Clin Psychiatry 46, 59 Exfoliative dermatitis Facial edema (<1%) Flushing (<2%) Furunculosis (<1%) Herpes simplex (reactivation) (1991): Reed SM+, Am J Psychiatry 148, 949 Herpes zoster Hot flashes Lichenoid eruption Lupus erythematosus (discoid) Mycosis fungoides (exacerbation) (1996): Vermeer MH+, J Am Acad Dermatol 35, 635 Nodules (sic) Peripheral edema (<1%) Petechiae (<1%) Photosensitivity (1998): Pazzagli L+, Pharm World Sci 20, 136 (with alprazolam) Phototoxicity (<1%) (1995): Gaufberg E+, J Clin Psychiatry 56, 486 (1995): O’Brien T, Australas J Dermatology 36, 103 Pigmentation (<1%) Pruritus (2.4%) (1993): Gupta RK+, Med J Aust 158, 722 (1991): Olfson M+, J Nerv Mental Dis 159, 504 (1985): Wernicke JF, J Clin Psychiatry 46, 59 Pseudo-mycosis fungoides (sic) (1996): Gordon KB+, J Am Acad Dermatol 34, 304 Psoriasis (<1%) (1992): Hemlock C+, Ann Pharmacother 26, 211 Purpura (<1%) Pustules (<1%) Rash (sic) (6%) (1989): Miller LG+, Am J Psychiatry 146, 1616 (1987): Zerbe RL, Int J Obes 11(Suppl 3), 191 (1985): Wernicke JF, J Clin Psychiatry 46, 59 Raynaud’s phenomenon (2000): De Broucker+, Ann Med Interne (Paris) 151(5), 424 Seborrhea (<1%) Stevens-Johnson syndrome

(1998): N Z Medicines Adverse Reactions Committee (from Internet) (observation) (1992): Bodokh I+, Therapie (French) 47, 441 Toxic epidermal necrolysis (1992): Bodokh I+, Therapie (French) 47, 441 (1991): Rosenthal E+, Presse Med (French) 20, 1459 Ulcerations (<1%) Urticaria (4%) (1994): Blumenthal HL, Beachwood, OH (personal case) (observation) (1993): Gupta RK+, Med J Aust 158, 722 (1992): Leznoff A+, J Clin Psychopharmacol 12, 355 (1991): Olfson M+, J Nerv Mental Dis 159, 504 (1989): Miller LG+, Am J Psychiatry 146, 1616 Vasculitis (1999): Fisher A+, Aust N Z J Med 29, 375 (focal necrotizing) (1995): Roger D+, Dermatology 191, 164 Xerosis

Hair Hair-alopecia (<1%)

(2000): Murlidhar MD, Madras, India (from Internet) (observation) (1996): Bhatara VS+, J Clin Psychiatry 57, 227 (1995): Seifritz E+, Can J Psychiatry 40, 362 (1995): Shelley WB+, Cutis 55, 144 (observation) (1994): Mareth TR, J Clin Psychiatry 55, 163 (1994): Shelley WB+, Cutis 53, 282 (observation) (1993): Ogilvie AD, Lancet 342, 1423 (1991): Ananth J+, J Psychiatry 36, 621 (1991): Gupta S+, Br J Psychiatry 159, 737 (1991): Jenike MA, Am J Psychiatry 148, 392 Hair-hirsutism (<1%)

Other Ageusia (<1%)

Anaphylactoid reactions (<1%) Aphthous stomatitis (<1%) Black tongue (2000): Heymann WR, Cutis 66, 25 Dysgeusia (1.8%) (2000): Heymann WR, Cutis 66, 25 Galactorrhea (2001): Peterson MC, Mayo Clin Proc 76, 215 Gingivitis (<1%) Glossitis (<1%) Glossodynia (1994): Shelley WB+, Cutis 53, 242 (observation) Gynecomastia (<1%)

(2003): Boulenger A+, J Eur Acad Dermatol Venereol 17(1), 109 Headache (2003): Calabrese JR+, J Clin Psychiatry 64(5), 562 (27%) Hyperesthesia (<1%) Hypersensitivity (1994): Beer K+, Arch Dermatol 130, 803 Mastodynia (<1%) Myalgia Myopathy (<1%) Oral ulceration (<1%) (2000): Madinier I+, Ann Med Interne (Paris) (French) 151, 248 Paresthesias (2001): Ribeiro L+, Braz J Med Biol Res 34(10), 1303 (1996): Bhatara VS+, J Clin Psychiatry 57, 227 Parosmia (<1%) Priapism (<1%) Pseudolymphoma (1995): Crowson AN+, Arch Dermatol 131, 925 (1995): Magro CM+, J Am Acad Dermatol 32, 419 (1988): Kardaun SH+, Br J Dermatol 118(4), 545 Rhabdomyolysis (1990): Lazarus A, J Clin Psychopharmacol 10 (overdose) Serotonin syndrome (2003): Birmes P+, CMAJ 168(11), 1439 (2002): Chechani V, Crit Care Med 30(2), 473 (2002): Lange-Asschenfeldt C+, J Clin Psychopharmacol 22(4), 440 (with tramadol) (2000): Manos GH, Ann Pharmacother 34(7-8), 871 (with buspirone) Serum sickness (1991): Vincent A+, Am J Psychiatry 148, 1602 (1989): Miller LG+, Am J Psychiatry 146, 1616 Sialorrhea (<1%) Stomatitis (<1%) Thrombophlebitis (<1%) Tinnitus Tongue edema (<1%) Tongue pigmentation (<1%) Tremor (2-10%) Vaginal anesthesia (1993): King VL+, Am J Psychiatry 150, 984 Xerostomia (12%) (2002): Krymchantowski AV+, Headache 42(6), 510 (with amitriptyline) (2000): Heymann WR, Cutis 66, 25 (1993): Beasley CM+, Ann Clin Psychiatry 5, 199 (1985): Wernicke JF, J Clin Psychiatry 46, 59