The Hypersomnia Foundation frequently receives questions about the use of flumazenil in treating idiopathic hypersomnia (IH) and related disorders. Most of the emails we receive ask how and where to find this medication. In response, we have researched flumazenil access and compiled the information in this list of “Frequently Asked Questions.”
1. Has flumazenil been approved by the U.S. FDA to treat IH? If not, can my physician still prescribe it to me for my IH symptoms?
Flumazenil is FDA-approved in the U.S. as an intravenous (IV) medication to reverse excessive or prolonged sedation suspected to be caused by benzodiazepines (e.g. Valium, Ambien, etc.). It is not FDA-approved for the treatment of idiopathic hypersomnia (IH) or any other central disorder of hypersomnolence. However, as with any medication approved by the FDA, physicians can choose to prescribe flumazenil “off-label” for indications other than that for which it is approved. This includes use of flumazenil for the treatment of IH and related disorders. Because flumazenil is currently approved in liquid form for IV use, it must be formulated into a transdermal cream or lozenge – for topical or mucosal absorption, respectively – by what is referred to as a compounding pharmacy for use by people with IH and related disorders.
2. I live outside the U.S., and flumazenil is not approved for any use in my country. Am I out of luck?
If you are not in the U.S., and flumazenil is NOT approved for any use in your country, WEP Clinical may be able to help you with access.
3. Is there any scientific evidence that flumazenil might help my IH symptoms?
Some relevant journal articles discussing the use of flumazenil in treating IH and related disorders are as follows:
- Modulation of vigilance in the primary hypersomnias by endogenous enhancement of GABAA receptors. Free Full Text.
- Flumazenil for the Treatment of Refractory Hypersomnolence: Clinical Experience with 153 Patients. Free Full Text. HF has also published a summary of this article.
4. Where can my doctor find flumazenil in a compounded form?
The Hypersomnia Foundation is aware of 3 compounding pharmacies that work with flumazenil:
Village Pharmacy of Lynnfield– Closed as of November 2019
5. Will my health insurance company pay for my flumazenil?
Many insurance companies will not pay for this medication to treat IH; however, a few will do so, often as part of their coverage for compounded medications. A first step is to review your insurance policy to determine if compounded medications are covered. You may be able to find further information via support groups, such as Facebook’s Flumazenil for Hypersomnia. Given that there are very few pharmacies in the U.S. that compound flumazenil, we understand from some patients that they have successfully argued with their insurance companies that they must cover the available compounding pharmacies as in-network, on the grounds that the insurance company can provide no in-network options for coverage. However, this is a question that each individual must ask of their own health insurance company, since coverage plans vary greatly. Read more HERE.
LEGAL DISCLAIMER: Please note that the information contained in these FAQs is for general informational purposes only. It is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your own personal physician concerning any condition or treatment.
In addition, please note that the support groups and Facebook pages referred to here are not sponsored by HF.