Midazolam (Injection)

Also known in the US as Versed, this drug is used during medical procedures or surgery to produce drowsiness or sleepiness or to relieve any anxiety associated with the procedure.

Overview

Midazolam is a drug used to induce drowsiness or sleepiness and to relieve anxiety before medical procedures or surgery. Midazolam can also be given to produce amnesia so that a patient won't remember any undesirable effects or discomfort that could occur after a medical procedure or surgery. It's also used to create a loss of consciousness during and before surgery. This drug is sometimes used to cause unconsciousness in patients in hospital intensive care units. This may help in assisting them to withstand the stress of being in an intensive care unit and help them cooperate when a device is required to assist with breathing.

This drug can only be given by or under the immediate supervision of a trained healthcare professional who knows exactly how to use this medication. If you will be receiving midazolam during surgery, your anesthesiologist or doctor will administer the medication and monitor your progress closely. You cannot obtain this medication on your own.

Midazolam is available in the following dosage form of solution for IV.

Conditions treated

  • Additional Agent to Induce General Anesthesia

Type of medication

  • Solution

Side effects

Alongside the intended effects of this medication, it's use can produce some unwanted side effects. You may not suffer from all these side effects at once, but if you do experience any, you should contact your doctor for advice.

Seek medical attention if you suffer from any of the following side effects whilst taking midazolam:

  • Apnea
  • Bradypnea
  • Variable blood pressure
  • Breathing problems
  • Confusion

You may suffer from other side effects not listed above. You should contact your healthcare team if you notice anything unusual.

Dosage

The final dose you receive of this medication will depend on individual factors. This will include your age, weight, and height, what other medications you are currently taking and any other medical conditions you may suffer from. Your doctor will also take into account, the strength of the medication, the type of surgery you are having, your reaction to the dose and your general overall health.

You will be given this medication in a hospital setting, so will not need to worry specifically about taking too much or too little of this medication. However, the typical dosing guidelines are noted below for reference.

IV for light sedation:

Typical dose: 1 to 2.5 mg slow IV every two minutes as required for sedation.

Interactions

It is possible that drug interactions may occur with this medication. This could cause severe side effects or prevent your sedation. To help limit these interactions from occurring, it's important your doctor is made aware of all the current medications you are taking. This should include all over the counter medications (prescription and nonprescription), any herbal products or vitamin supplements. You should also make your health care team aware of any other medical conditions you may suffer from as these too could increase your risk of interactions with this drug. In most cases, your doctor will avoid this drug if interactions are likely, but in rare cases, it may still be necessary.

The use of this medication alongside any of the following is not typically recommended. Your doctor may avoid treating you with this drug or alter some of the other drugs you are currently taking.

  • Indinavir

The use of this medication alongside any of the following is not typically recommended, but in some cases, it may still be necessary. If you are prescribed both medications together, your doctor may alter the dose or how often you use either medication.

  • Pentobarbital

The use of this medicine alongside any of the following drugs could increase your risk of certain side effects, however, the use of both drugs may still be the best treatment for you. If you are given both drugs together, your doctor may change the dose or frequency in which you use either drug.

  • Roxithromycin

  • Dalfopristin
  • Armodafinil

Other Interactions

Specific medications should be avoided alongside the consumption of food or certain types of food as it could increase the risk of interactions. The use of alcohol and tobacco alongside specific medications could also cause interactions to occur.

The use of this medication alongside any of the following substances is not recommended, however, in some cases, it may be unavoidable. If you use both together, your doctor may change your dose or give you specific instructions about the use of this drug alongside this product.

  • Ethanol

Other Medical Problems

If you suffer from other medical conditions, this could affect the use of midazolam. You need to make your doctor aware of any other medical problems you may suffer from, including:

  • Obesity: The effects of this drug may last longer.

Warnings

Before you decide to receive this drug, there are a number of things to consider. These should be considered alongside your doctor before you come to a decision of whether to use Midazolam or not.

Allergies

Make your health team aware if you have ever suffered from an allergic reaction to this medication or any other medication. You should also make them aware of any other allergies you may suffer from, including to animals, dyes, preservatives or foods.

Pediatric population

Newborn babies can be especially sensitive to the effects of this drug. This could increase the chance of side effects occurring whilst using midazolam. Also, the time it takes to completely recover after you receive this drug may be longer in extremely ill newborns.

Geriatric population

Older people are more sensitive to the effects of midazolam. This has the potential to increase the chance of side effects occurring whilst using this medication. Also, the recovery time after receiving this drug may be slower in the elderly population than younger adults.

Use in pregnancy and breastfeeding

This drug is under FDA pregnancy category D. This drug could cause harm to an unborn child when pregnant. You should let your doctor know if you are pregnant whilst receiving this medication. In some cases, the benefits of therapy in a life-threatening situation may outweigh the associated risk. You should discuss this with your doctor.

To date, there is no evidence that suggests that this drug can pass through breast milk during feeding. Caution should be exercised and you should discuss with your doctor the potential risks and benefits.

For patients who return home within a twenty-four hour period after receiving this drug:

Midazolam can cause some people to feel weak, tired, or drowsy, for one or two days after they have received it. It can also cause issues with the ability to think and general coordination. Therefore it's important that you do not use machinery, drive or do any other activity that could be dangerous if you are not alert. You should avoid these activities until the effects of this medication have finished, or until the day after you receive this drug, whichever is the longer period of time.

Don't consume alcoholic beverages or take other CNS depressants (medication that slows down the nervous system) for at least twenty-four hours after you have received this drug unless your doctor has told you otherwise. If you do, it could add to the effects of the medication. Some examples of CNS depressants include medication for hay fever, colds, or other allergies, antihistamines, other tranquilizers, sedatives, or medication to help you sleep, prescription pain medication or narcotics, muscle relaxants or medication for seizures.

Storage

You will receive this medication in a hospital or clinic setting by a trained healthcare professional. You will therefore not need to worry about home storage for midazolam.

Summary

When used as directed, this drug acts as a successful sedative used in medical procedures or surgery. Due to a large number of interactions possible, you should ensure that your healthcare professional is aware of all medications you are currently taking. This drug should not be used during pregnancy, but in some cases, it may still be necessary. You should let your doctor know if you are pregnant. The effects of this drug and the recovery time could be increased in infants and elderly patients, therefore, caution should be exercised. This drug can increase your risk of addiction in some patients, however, this is more likely in those patients who already suffer from an addiction. Your dose will be determined by your individual factors. You may feel dizzy, tired or drowsy for up to two days after you receive this medication, so exercise caution in daily activities and avoid driving. If you require any further information about the practical uses of this drug, or you have more questions you wish to be answered, you should contact your local healthcare team for more advice.