Midazolam

Description

Midazolam is a medication used to induce drowsiness, relieve anxiety, and prevent memory of events before minor surgery, dental work, or other medical procedures. It may also be used for short-term treatment of insomnia (difficulty falling asleep). The medication works by slowing activity in the brain, causing relaxation and decreased consciousness. Midazolam may cause some side effects like nausea, vomiting, drowsiness, dizziness, blurred vision, etc. Inform your doctor if these side effects become severe or persist for a long time. Midazolam is available on prescription as tablet, syrup, injection and nasal spray. The oral form can be taken with or without food. The injection form is administered by a healthcare professional in a hospital or clinic setting. Midazolam should be taken with caution if you have taken opioid medicines (medicines prescribed to treat severe pain) as it may slow or stop your breathing. Inform your doctor about any other medications you are taking because some may interact with or be impacted by this medication. If you are pregnant or are breastfeeding, consult your doctor before taking this medicine.

Side effects

Major & minor side effects for Midazolam

  • Anxiety
  • Chest pain and discomfort
  • Confusion
  • Drowsiness
  • Irregular heart beat
  • Irritability
  • Nausea and Vomiting
  • Nervousness
  • Shortness of breath
  • Rash

Uses of Midazolam

What is it prescribed for?

  • Light Sedation
  • Light Anesthesia
  • Insomnia
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Concerns

Commonly asked questions

  • Onset of action
    The time required for Midazolam to show its action time may differ depending on the type of dosage form. The onset of action for each preparation is as follows: IM Injection (Intramuscular) : Children: Within 5 minutes; Adults:15 minutes. IV Injection (intravenous or into the vein): 1 to 5 minutes Oral: 10 to 20 minutes. Intranasal (nasal spray): Within 10 minutes. Intranasal (solution, injection): Children: 5-7 minutes, Adults: Within 5 minutes.
  • Duration of effect
    Duration of action of Midazolam differs as per the form in which it is administered. Follow are the duration of action as per the dosage form: IM Injection (Intramuscular): upto to 6 hours IV Injection (intravenous or into the vein) <2 hours Intranasal (solution, injection): Children: 20-25 minutes
  • Safe with alcohol?
    Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
  • Is it habit forming?
    Midazolam may become habit-forming in some cases. Inform your doctor if your experience any changes in behaviour or mood during treatment with this medicine.
  • Usage in pregnancy?
    Midazolam is not recommended during pregnancy, as it may cause serious complications in the development of your foetus. Your doctor may advise a safer alternative with the same therapeutic effect based on your clinical condition.
  • Usage while breast-feeding?
    Midazolam is not recommended if you are a nursing woman as this medicine may pass into your breast milk and harm your baby. Your doctor may advise a safer alternative with the same therapeutic effect based on your clinical condition.

Allergy

Avoid taking Midazolam if you are allergic to it. Allergic reactions are rare; however, contact a doctor immediately if you experience symptoms like rashes, itching/swelling (particularly of the face/tongue/throat), severe dizziness, and breathing difficulty, etc.

Narrow-angle glaucoma

Narrow-angle glaucoma is a sudden rise of intraocular pressure (pressure within your eye) due to blocked drainage canals in your eyes. Midazolam is not recommended for use in such cases as it can worsen your condition.

Acute alcohol intoxication

Acute alcohol intoxication is also known as alcohol poisoning. It is a condition caused by consuming an excessive amount of alcohol in a short amount of time. Its symptoms are slurred speech, incoordination, mood and behaviour changes. It is not recommended to consume alcohol while you are on treatment with Midazolam because it can cause acute alcohol intoxication, severe respiratory depression, and life-threatening problems.
Warnings for special population

Pregnancy

Midazolam is not recommended during pregnancy, as it may cause serious complications in the development of your foetus. Your doctor may advise a safer alternative with the same therapeutic effect based on your clinical condition.

Breast-feeding

Midazolam is not recommended if you are a nursing woman as this medicine may pass into your breast milk and harm your baby. Your doctor may advise a safer alternative with the same therapeutic effect based on your clinical condition.
General warnings

Paradoxical reactions

Paradoxical reactions refer to the reactions to medication that worsen the symptoms for which the medicine was prescribed. Therefore, it is important to use Midazolam with caution due to the increased risk of paradoxical reactions, such as excitability, nervousness, hostility, nightmares, sleep disturbances, and other related symptoms. This risk is particularly high in people with mental disorders. If you notice any changes in your mood or behaviour during treatment with this medication, inform your doctor immediately.

Impaired kidney and liver function

Midazolam is broken down in your liver and excreted through urine. If you have problems with your liver and kidney function, this medicine can further worsen it. Hence take caution if you have such conditions.

Missed Dose

Tablets: If the tablets are used for insomnia, take the missed dose as soon as you remember. Skip the missed dose if it is already daytime. Try not to miss any dose as the quantity and timings are very specific and non-adherence could cause some side effects. Injection/Syrup/Nasal spray/Tablets: Since this medicine is given by a qualified healthcare professional either in emergency situations or preoperatively, the likelihood of missing a dose is very low.

Overdose

Tablets used for insomnia: Seek emergency medical treatment or contact your doctor in case of an overdose. Injection/Syrup/Nasal Spray/Tablets: Since Midazolam is administered either in emergency situations or preoperatively by a qualified healthcare professional, the likelihood of an overdose is very low. However, emergency medical treatment will be initiated by your doctor if an overdose of this medicine is suspected.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.

Instructions

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Medicine

Amitriptyline

Clozapine

Fluconazole

Disease interactions

Respiratory Depression

Respiratory depression or hypoventilation is a breathing disorder that occurs when there is not enough gas exchange between the lungs and the atmosphere, thus causing slow and ineffective breathing. Midazolam should be taken with extreme caution if you have respiratory depression due to the increased risk of worsening your condition.

Congestive heart failure

Congestive heart failure is a condition in which the heart is unable to pump blood efficiently. Midazolam may worsen your condition; hence take it with caution if you have a history of congestive heart failure.

Depression

Depression is an alteration in a person's mood. Midazolam should be taken with caution if you have depression or any other disorders of the nervous system as it may worsen your condition.

Obesity

Obesity is a medical condition characterized by an unhealthy accumulation of body fat. If you are obese, it is recommended to use Midazolam with caution due to an increased risk of severe side effects. If you experience any unusual symptoms, notify your doctor immediately. Your doctor may suggest an alternative medication or adjust the dosage as necessary.
Food interactions
Consumption of grapefruit or grapefruit juice is not recommended during treatment with Midazolam due to the increased risk of serious and life-threatening reactions.
Lab interactions
Information not available.
Tablets: Take Midazolam as instructed by your doctor. Your dose is likely to be changed by your doctor during the course of treatment and hence all changes should be properly followed. Do not consume this medicine in larger or smaller quantities than prescribed. You are likely to experience some side effects whenever there is a change in dose quantity or timings. The usage should be stopped gradually over time as instructed. Injection/Syrup/Nasal Spray: This medicine is usually administered by a qualified healthcare professional. Follow all the instructions given by your doctor.
Miscelleneous

Usage does not depend on food timings

To be taken as instructed by doctor

Causes sleepiness

How it works
Midazolam minimizes the activity in your brain and induces relaxation, drowsiness, and sleep.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Benzodiazepines

Schedule

Schedule H1

2021. [online] Available at: [Accessed 16 November 2021].

https://www.medicines.org.uk/emc/medicine/1692

Dailymed.nlm.nih.gov. 2021. DailyMed - MIDAZOLAM- midazolam hydrochloride injection. [online] Available at: [Accessed 16 November 2021].

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=737361a0-8db1-4d3c-ba5e-44df3f49fa22

Drugs, H., 2021. Midazolam Injection: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: [Accessed 16 November 2021].

https://medlineplus.gov/druginfo/meds/a609014.html

CiplaMed. 2021. MIDACIP Nasal Spray. [online] Available at: [Accessed 16 November 2021].

https://ciplamed.com/content/midacip-nasal-spray

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Information on this page was last updated on 3 Mar 2023

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