Midazolam Pharmacology


About Midazolam
An ultra short-acting benzodiazepine derivative, Anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant,Sedative.
Mechanism of Action of Midazolam
Midazolam mainly acts on Limbic system and ascending reticular formation in the CNS and binds to the BZD receptor. The binding will facilitates GABA mediated chloride channel opening and produce hyperpolarisation. This will produce an increase in the concentration of the inhibitory neurotransmitter GABA and chloride ions and decreases firing rate of neuron. This in turn alters normal functions of the body.
Midazolam is used as adjuncts in anaesthesia for anxiolysis, amnesia and sedation prior to induction of anaesthesia
Pharmacokinets of Midazolam
Absorption: It is well absorbed after parenteral administration. Distribution: It is distributed widely in the body in protein bound form. Metabolism: It is metabolised in the liver. Excretion: Drug is excreted in urine

Onset of Action for Midazolam
10 - 20 minutes (parenteral)
Duration of Action for Midazolam
2-6 hours.
Half Life of Midazolam
1 - 13 hour
Side Effects of Midazolam
3.Light headedness
4.Slurred speech
6.Constipation or diarrhoea
11.Light headedness
12.Mood changes
13.Muscle rigidity
Contra-indications of Midazolam
1.Hypersensitivity to Benzodiazepines
2.Acute angle closure glaucoma
3.Patients in shock
5.Acute alcohol intoxication
Special Precautions while taking Midazolam
1.Renal impairment
2.Hepatic impairment
3.Use caution while driving vehicles or operating machines or people involving any other dangerous activities

Pregnancy Related Information
Old Age Related Information
Use with caution
Breast Feeding Related Information
Children Related Information
Use with caution
NEONATES contraindicated
Indications for Midazolam
2.In general anaesthesia
3.Sedative prior to endoscopic and diagnostic procedure
Interactions for Midazolam
Anaesthetics (inhalation): Inhalational anaesthetics may need to be reduced if midazolam is used as induction agent I.V.
Azole antifungal agents: Enhanced CNS depession and prolonged effects.
CNS depressants: May increase risk of hypoventilation and contribute to prolonged effect.
Ethanol: Increased CNS effects with acute ethanol ingestion.
Oral contraceptives: May result in prolongation of midazolam half life.
Rifamycin: Increase in midazolam & metabolite clearance & decrease in elimination half life.
Theophylline: Sedative effect of midazolam may be antagonised.
Thiopental: A reduction in induction dosage requirement of thiopental.
Verapamil: May produce increased CNS depression and prolonged effects.
Typical Dosage for Midazolam
Sedative (IM injection): 0.7 - 0.8 mg / kg body weight; 30 - 60 minutes before surgery
Conscious sedation: 1-2 mg is given as slow IV injection. The dose can be increased by 0.5 - 1 mg every 2 minutes until the desired effect is produced. Total dose up to 7.5 mg may be used.
In general anaesthesia as an inducer:
A. Unpremedicated: 300 - 350 mcg / kg body weight (as slow IV injection for 30 seconds). The dose can be increased by 25 % of the initial dose to produce the desired effect.
B. Premedicated: 250 mcg / kg body weight (as slow IV injection for 30 seconds).
Continuous sedation for patients in intensive care unit: 10 - 50 mcg / kg body weight as IV infusion. Maintenance dose: 20 - 100 mcg / kg / hour. The dose can be increased or decreased by 25 - 50 % of the initial dose to produce the desired effect.
Continuous sedation for patients in intensive care unit: 50 - 200 mcg / kg body weight as IV infusion. Maintenance dose: 60 - 120 mcg / kg / hour. The dose can be increased or decreased by 25 - 50 % of the initial dose to produce the desired effect.
Sedative for short procedure (IM): 0.1 - 0.15 mg / kg. The dose can be increased up to 0.5 mg / kg

Schedule of Midazolam
Storage Requirements for Midazolam
The drug should be kept at 15 - 30 degree C.Protect away from light. Keep out of the reach of children.

Effects of Missed Dosage of Midazolam
Does not apply
Effects of Overdose of Midazolam
Give support and symptomatic treatment. Flumazenil can be given as antagonist. Hypotension can be treated with IV fluid or vasopressors.

Home Delivery for Midazolam in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including midazolam.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for midazolam and other medicines and health products. Home delivery services for midazolam may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take midazolam only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for midazolam before they complete the sale. You can get this information while placing the order for midazolam with the pharmacy.

Midazolam is a generic medicine name and there are several brands available for it. Some of the brands for midazolam might be better known than midazolam itself. If the pharmacy that's willing to deliver medicines to your home doesn't have midazolam in stock, you can ask for one of the branded alternatives for midazolam.