Generic
Midazolam
34 brands available in the market
At a glance
Midazolam is a benzodiazepine used for sedation or conscious sedation before diagnostic or therapeutic procedures.
Description
Midazolam is a short-acting benzodiazepine with sedative hypnotic muscle relaxant anxiolytic and anticonvulsant actions. It increases the action of GABA which suppresses abnormal nerve cell activity in the brain.
Indications
- Conscious sedation before diagnostic or therapeutic procedures
- Short-term treatment of insomnia
- Preoperative sedation
Therapeutic class
Benzodiazepine Hypnotics and Sedatives
Pharmacological class
Benzodiazepine
Pharmacology
Midazolam's actions are mediated through GABA the major inhibitory neurotransmitter in the CNS. Benzodiazepines increase GABA activity producing sedative effects and relaxing skeletal muscles.
Mechanism of action
Increases GABA activity to suppress nerve cell activity and produce sedation.
Dosage
Adult Dose (Oral):
- Insomnia: 7.5-15 mg at bedtime
- Elderly: 7.5 mg at bedtime
- Pre-medication: 15 mg 30-60 minutes before procedure
Parenteral:
- Preoperative Sedation IM: 0.07-0.1 mg/kg
- Endoscopic Procedures IV: 2.5 mg
- Anesthesia IV: 10-15 mg
Child Dose: 0.15-0.20 mg/kg IM
Administration
- Use only under healthcare professional supervision
- For nasal spray: keep head upright while spraying
- Follow prescribed dose and duration
Missed dose
If you miss a dose take it as soon as you remember; skip if its almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Nasal discomfort
- Throat irritation
- Headache
- Drowsiness
- Confusion
- Muscle weakness
Serious Side Effects:
- Respiratory depression
- Apnea
- Blood pressure variations
Precautions & warnings
- High habit-forming potential
- Caution while driving (may cause dizziness)
- Avoid alcohol
- Do not stop abruptly
- Caution in pregnancy and lactation
Contraindications
- Severe respiratory insufficiency
- Severe hepatic insufficiency
- Myasthenia gravis
- Sleep apnea syndrome
- Acute narrow-angle glaucoma
- Hypersensitivity to benzodiazepines
- Concomitant use with potent CYP3A4 inhibitors
Drug interactions
- Alcohol and Opioids: Increased CNS depression
- CYP3A4 Inhibitors (cimetidine erythromycin ketoconazole): Increased plasma concentrations
- Phenytoin Carbamazepine Rifampicin: Decreased midazolam concentration
Food interactions
Alcohol with Midazolam may cause excessive drowsiness.
Use in pregnancy
Unsafe during pregnancy (Category D). Use only in life-threatening situations.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Probably safe during lactation. Use for short periods and monitor baby for sleepiness.
Pediatric use
Pediatric dose established: 0.15-0.20 mg/kg IM
Geriatric use
Elderly: 7.5 mg at bedtime (oral)
Renal / hepatic impairment
Renal Impairment: No interaction found.
Hepatic Impairment: Mild-moderate: dose reduction needed; Severe: contraindicated.
Overdose effects
Extreme overdosage may lead to coma areflexia cardiorespiratory depression and apnea. Can be controlled with flumazenil.
Storage conditions
Protect from light and moisture. Store in cool and dry place. Keep out of reach of children.
Chemical structure
Midazolam