Midazolam
Generic Details
Generic Name
Midazolam
Other Names
- Versed
- Dormicum
Drug Class
- Benzodiazepine
Chemical Formula
C18H13ClFN3
Molecular Weight
325.77 g/mol
Mechanism of Action
- Enhances the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, leading to sedative, anxiolytic, and amnesic effects.
Indications
- Anesthesia induction and maintenance
- Sedation before medical procedures
- Acute seizures
- Status epilepticus
Common Dosage Forms
- Oral tablets
- Oral liquid solution
- Injectable solution
Typical Dosage
- 2-4 mg orally for sedation before procedures
- 0.07-0.1 mg/kg intravenously for anesthesia induction
Pediatric Dosage
- 0.05-0.2 mg/kg intravenously for sedation or anesthesia induction
Geriatric Dosage
- Lower initial doses with cautious titration to effect
Side Effects
- Respiratory depression
- Hypotension
- Drowsiness
- Confusion
- Amnesia
- Nausea
- Vomiting
Contraindications
- Hypersensitivity to benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
Pregnancy Category
- Category D - Positive evidence of risk
- Benefit should outweigh risk
Lactation Safety
- Limited data available, caution advised
Drug Interactions
- CNS depressants potentiation
- CYP3A4 inhibitors increase midazolam levels
Overdose Symptoms
- Somnolence
- Confusion
- Respiratory depression
- Coma
Antidote for Overdose
- Flumazenil (Benzodiazepine receptor antagonist)
Storage Conditions
- Store at controlled room temperature (20-25°C)
- Protect from light and moisture
Pharmacokinetics
- Absorption: Rapid and complete oral absorption
- Distribution: Highly lipophilic, distributes to CNS and other tissues
- Metabolism: Hepatic metabolism via CYP3A4 to inactive metabolites
- Excretion: Mainly renal excretion of metabolites
Precautions
- Respiratory monitoring during administration
- Use with caution in elderly or debilitated patients
- Avoid abrupt discontinuation
Warnings
- Risk of respiratory depression
- Risk of abuse and dependence potential