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Midazolam is a prescription benzodiazepine and Schedule IV controlled substance. This page focuses on injectable midazolam used for preoperative sedation, anxiety reduction, and amnesia, procedural sedation, anesthesia, and sedation during mechanical ventilation. Injectable products include concentrations of 1 mg per mL and 5 mg per mL. Other formulations have separate indications, including seizure treatment.
read more about midazolam ...Midazolam binds to benzodiazepine sites on gamma-aminobutyric acid type A receptors in the central nervous system. It increases the inhibitory effects of GABA, producing sedation, anxiety reduction, muscle relaxation, and impaired formation of new memories during its activity.
Injectable midazolam is administered to adults and selected pediatric patients before or during procedures requiring sedation or anesthesia. It is also used for sedation of intubated patients in appropriate care settings. Administration requires personnel trained in airway management and continuous respiratory and cardiovascular monitoring. Specific pediatric and neonatal regimens depend on the product and route.
Intravenous procedural sedation in healthy adults younger than 60 commonly begins with 1 mg to 2.5 mg administered slowly over at least two minutes, followed by reassessment before further doses. Lower initial doses are used in older or debilitated adults and patients receiving other sedatives. Intramuscular preoperative sedation in selected adults younger than 60 uses approximately 0.07 mg to 0.08 mg per kg. Pediatric doses are weight-based and individualized.
Injectable midazolam carries boxed warnings for respiratory depression, respiratory arrest, and potentially fatal complications without appropriate monitoring and resuscitation equipment. Concomitant opioids can cause profound sedation, respiratory depression, coma, and death. Other concerns include low blood pressure, impaired breathing, paradoxical agitation, and prolonged sedation. Continuous monitoring is required during administration and recovery.
It is used for preoperative and procedural sedation, anxiety reduction, amnesia, and selected anesthesia or critical care regimens.
Healthy adults younger than 60 can begin with 1 mg to 2.5 mg administered slowly, followed by clinical reassessment.
Yes. Midazolam is a Schedule IV controlled substance.
Yes. The warnings address serious respiratory complications, the need for appropriate monitoring, and potentially fatal interactions with opioids.
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