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Midazolam Hydrochloride Solution for injection

It is used to cause relaxation or sleep before surgery and to block memory of the procedure

Generic Name: midazolam

Brand Names: Midazolam Hydrochloride, Versed

There is an FDA Alert for this drug. Click here to view it.

  • Use only when adequate treatment facilities for appropriate management of therapy and complications are available.
  • For deeply sedated pediatric patients, an individual other than the clinician performing the procedure should be dedicated to monitoring the patient throughout the procedure.

    Respiratory Effects
  • Associated with respiratory depression and respiratory arrest, especially when used for sedation in non-critical-care settings. (See Respiratory and Cardiovascular Effects under Cautions.)
  • Death or hypoxic encephalopathy has resulted when respiratory depression was not recognized promptly and treated effectively.

    Dosage and Administration Considerations for Procedural Sedation
  • Initial IV dose for healthy adults should not exceed 2.5 mg. (See Dosage under Dosage and Administration.)
  • Lower dosages are necessary in patients >60 years of age, debilitated patients, and patients receiving concomitant opiates or other CNS depressants. (See Dosage and also Special Populations, under Dosage and Administration.)
  • Titrate initial and subsequent dosages slowly; administer the appropriate dose over ≥2 minutes and wait an additional 2 or more minutes to fully evaluate the sedative effect.
  • Administer by direct IV injection as the 1-mg/mL solution or dilute the 1- or 5-mg/mL solution to facilitate slower administration.

    Pediatric Dosage and Administration Considerations
  • Calculate pediatric dosage on a mg/kg basis. Initial dose is dependent on age, procedure, and route; titrate subsequent dosages slowly. (See Dosage: Pediatric Patients, under Dosage and Administration.)
  • Do not administer by rapid IV injection in neonates. Severe hypotension and seizures have been reported following rapid IV administration, particularly with concomitant administration of fentanyl.

What is this medicine?

MIDAZOLAM (MID ay zoe lam) is a benzodiazepine. It is used to cause relaxation or sleep before surgery and to block memory of the procedure.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • an alcohol or drug abuse problem
  • bipolar disorder, depression, psychosis, or other mental health condition
  • glaucoma
  • heart disease
  • kidney disease
  • liver disease
  • lung or breathing disease
  • seizures or a history of seizures
  • suicidal thoughts
  • an unusual or allergic reaction to midazolam, other benzodiazepines, benzyl alcohol, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This medicine is for injection into a muscle or vein. It is given by a health care professional in a hospital or clinic setting.

Talk to your pediatrician regarding the use of this medicine in children. While this medicine may be prescribed for children for selected conditions, precautions do apply.

What if I miss a dose?

This does not apply.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
  • delavirdine
  • efavirenz
  • grapefruit juice
  • itraconazole
  • ketoconazole
  • protease inhibitors for HIV infection or AIDS

This medicine may also interact with the following medications:

  • cimetidine
  • diltiazem
  • droperidol
  • general anesthetics
  • prescription pain medicines
  • rifampin, rifapentine, or rifabutin
  • secobarbital
  • some antibiotics like clarithromycin, erythromycin, and troleandomycin
  • some medicines for seizures like carbamazepine, phenobarbital, phenytoin, and primidone
  • thiopental
  • verapamil

What should I watch for while using this medicine?

Your condition will be monitored carefully while you are receiving this medicine.

The effects of this medicine can last for several hours after use. It can affect your ability to drive or do anything that needs mental alertness. Do not attempt to drive yourself home if you have received this medicine for minor outpatient surgery. You may feel dizzy and lightheaded. To reduce the risk of dizzy or fainting spells, do not sit up or stand up quickly, especially if you are an older patient. Alcohol can make you more drowsy or dizzy. Avoid alcoholic drinks for at least 24 hours after you receive this medicine.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
  • difficulty breathing, wheezing
  • disorientation, or hallucinations during recovery
  • dizziness or lightheadedness
  • fast or irregular heartbeat
  • numbness or tingling in the hands or feet
  • pain, redness, or swelling at the injection site
  • seizures
  • skin rash or itching

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • coughing, hiccups
  • difficulty sleeping, nightmares
  • drowsiness
  • headache
  • involuntary eye and muscle movements
  • loss of memory of events just before, during, and after use
  • nausea, vomiting
  • speech difficulty

Where should I keep my medicine?

This drug is given in a hospital or clinic and will not be stored at home.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Last Updated: June 25, 2009
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