Midazolam

Midazolam is a very short-acting parenteral benzodiazepine. Midazolam is used intramuscularly or intravenously for conscious sedation during minor surgical or diagnostic procedures, as an inducing agent, or as an adjunct to regional anesthesia. It was originally thought to be preferable to other benzodiazepines for conscious sedation because of its potency and its short duration of action, however, comparisons with diazepam, an agent with a much longer half-life, have not revealed a consistent advantage of it. It received FDA approval in December 1985. It can produce any level of CNS depression required including sedation, hypnosis, skeletal muscle relaxation, or anticonvulsant activity. The action of Midazolam is mediated through the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Midazolam is also used in the treatment of anxiety and seizures.

Brands
MIDAZOM HYPOZAM HYPOZAM IDAZOL MIZAM MILAM MILAM DAZOLAM DORMICUM DORMICUM DORCOM NOCTRUM XEPULSE DOMI DOMI DOMI SLEWELMILAM DOCUM LEADOLAM SURGISAFE SOMNIUM MIDZA M-LAM DIZILAM
Adult Dose
Dose: 2 mg
Single Dose: 2 (2)
Frequency: As recommended.
Route: IV
Instructions: Initial dose over 30 sec. followed after 2 min. by increments of 0.5 -1 mg, usual range 2.5-7.5mg
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Characteristics
. It is of Synthetic origin and belongs to Benzodiazepine. It belongs to Chloride Channel Potentiater (GABA operated) pharmacological group on the basis of mechanism of action and also classified in General Anesthetics and Benzodiazepine pharmacological group.The Molecular Weight of Midazolam is 325.80. Its pKa is 6.2.
Contraindications
Midazolam is contraindicated in conditions like Respiratory insufficiency.
Effects
The signs and symptoms that are produced after the acute overdosage of Midazolam include Coma, Confusion, Impaired impulse conduction, Sedation, Somnolence, Impaired coordination, Loss of reflexes.The symptomatic adverse reactions produced by Midazolam are more or less tolerable and if they become severe, they can be treated symptomatically, these include Headache, Drowsiness, Blurred vision, Rashes, Confusion, Erythema, Pain, Somnolence, Thrombophlebitis, Nausea and vomiting, Slurred speech, Agitation, Involuntry muscle movements, Muscle rigidity, Induration, Hiccups, Tenderness, Confusion, Pruritis.
Indications
Midazolam is primarily indicated in conditions like All forms of epilepsy, Anxiety, Induction of anaesthesia, Insomnia, Myoclonus, Sedation of patients receiving intensive care, Sedation with amnesia, Sedative in combined anaesthesia, Status epilepticus (unlicensed use), and can also be given in adjunctive therapy as an alternative drug of choice in Anesthesia, Surgery.
Interactions
Midazolam is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcoholAmprenavirIncreased risk of prolonged sedation and respiratory depression when Amprenavir given with Midazolam.CilostazoleCimetidine (HCl)DabrafenibDabrafenib decreased systemic exposure of midazolam (a substrate of CYP3A4) Substitute for these medications or monitor patients for loss of efficacy.Diltiazem (HCl)Fentanyl (Citrate)iloperidoneIndinavir (Sulphate)Indinavir increases the plasma concentration and pharmacological effect of midazolamby inhibiting intestinal and hepatic metabolism.MajorConcomitant use is considered contraindicated.ItraconazoleKetamine (HCl)LevodopaNelfinavirNevirapineNilotinibnilotinib increases midazolamexposure by 30%Caution should be exercised when co-administering Tasigna with substrates for these enzymes that have a narrow therapeutic indexPemolinePemoline may decrease seizure threshold. Efficacy of anticonvulsants may be decreased Phenytoin (Na)RanitidineRitonavirSt.Johns Wort ExtractConcurrent use may decrease the midazolam concentrations.Verapamil (HCl)VORICONAZOLEVoriconazole may increase the serum concentration of midazolam by decreasing its metabolism.Monitor for midazolam toxicity These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
interfere with clinical laboratory tests results
Risks
Drug should not be given to Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store Below 40°C. Protect from Sunlight and Moisture.
Warnings
Midazolam should be used with caution in patients with heart, kidney, liver or lungs diseases, in narrow angle glaucoma. It should be used with caution in elderly patients.
Back to List

Any information that appears on this website page is provided for the purpose of general information. This website has been compiled in good faith by HMIS.Online. However, no guarantee is made as to the completeness, validity or accuracy of the information it contains.