Midazolam is a drug used for sedation. It is in the benzodiazepine family, the same family that includes lorazepam (Ativan), diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), flurazepam (Dalmane), and others. It is thought that excessive activity of nerves in the brain may cause anxiety and other psychological disorders. Gamma-aminobutyric acid (GABA) is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another. GABA reduces the activity of nerves in the brain. Midazolam and other benzodiazepines may act by enhancing the effects of GABA in the brain. The FDA approved midazolam in December 1985.

GENERIC AVAILABLE: Yes

Yes

During surgery midazolam is used for sedation, reducing anxiety, and helping patients forget the surgical experience. It also is given before anesthesia and to maintain anesthesia. Patients who are intubated for control of respiration are given midazolam for sedation. Midazolam also is used for treating seizures.

The most common side effects associated with midazolam are:

• sedation,
• difficulty breathing,
• nausea,
• vomiting, and
• pain at the injection site.

Midazolam is given by intramuscular or intravenous injection. The dose for sedation during surgery is 0.5 to 1 mg given over 2 minutes and not to exit 2.5 mg per dose. Doses may be repeated after 2 to 3 minutes. Total doses greater than 5 mg usually are not needed. The dose for starting anesthesia is 200 to 350 mcg/kg injected intravenously over 20 to 30 seconds.

Midazolam and all benzodiazepines interact with other medications and drugs that slow the brain's processes such as alcohol, barbiturates, narcotics, and tranquilizers. Boceprevir (Victrelis), itraconazole (Sporanox), nelfinavir (Viracept), and telaprevir (Incivek) increase blood level of midazolam by reducing its breakdown in the liver and, therefore can increase the side effects of midazolam.

Midazolam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Midazolam is best avoided if at all possible in the first trimester and probably throughout pregnancy.

Midazolam is secreted in breast milk.

What preparations of midazolam-injection are available?

Injection: 1 and 5 mg/ml

How should I keep midazolam-injection stored?

Midazolam should be stored at room temperature, between 59 F and 86 F (15 C and 30 C) away from light and moisture.