midazolam
Midazolam is used for sedation before surgery and other medical procedures in children and adults, as well as treatment for status epilepticus (long-lasting seizures) in adults. It comes as an injection and oral syrup. The medication is typically given by a healthcare provider in a monitored setting and can't be used at home. Some side effects of midazolam include nausea, agitation, drowsiness, and pain at the injection site for the injection form. And although the brand name Versed has been discontinued, there are many generics still available.
What is Midazolam?
What is Midazolam used for?
- Sedation for surgery or other medical procedure
- Long-lasting seizure (status epilepticus) - Seizalam
How Midazolam works
Midazolam is a fast-acting benzodiazepine. It slows down activity in your brain and spinal cord and causes sedation, anxiety relief, and memory loss (amnesia) for a short period of time.
The way it works to treat long-lasting seizures isn't fully known, but it's thought to involve slowing down signals in the brain.
Drug facts
Risks and warnings for Midazolam
Midazolam can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe difficulty breathing
- Risk factors: Taking midazolam with opioids, alcohol, or other sedating medications | History of breathing problems
Midazolam can cause severe drowsiness, tiredness, and trouble breathing. This can be worse if opioid medications are also used for the procedure. If you're receiving midazolam for sedation before a procedure, your care team will start the medication in small doses and will monitor your breathing very carefully.
Continued memory problems after procedure
You might have memory problems and feel drowsy or "out of it" for a few hours after your procedure. If you're not admitted to the hospital, you'll most likely need someone to drive you home and take care of you. You might also feel dizzy and uncoordinated, which raises your risk of falls. Don't drive or operate machinery until the effects of midazolam have worn off or until after 1 day after the procedure, whichever is longer.
Harm to unborn baby if used in late pregnancy
Midazolam can cause harm to your unborn baby if the medication is used late in pregnancy. Babies whose mothers have taken benzodiazepines during pregnancy have experienced trouble breathing, extreme sleepiness, and withdrawal symptoms right after birth. If you're planning to conceive or are already pregnant, let your healthcare provider know so they can make adjustments.
Worsening of glaucoma
Midazolam can raise pressure in the eye, which could worsen glaucoma. Tell your provider if you've ever been told you have glaucoma so they can make sure this medication is safe for you.
Side effects of Midazolam
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Oral syrup
- Vomiting (8%)
- Nausea (4%)
Injection for sedation
- Pain at injection site (4-5%)
- Hiccups (4%)
- Nausea (3%)
- Vomiting (3%)
Injection for long-lasting seizure
- Upper airway blockage (5%)
- Agitation (4%)
- Fever (4%)
- Confusion (3%)
Less Common Side Effects
- Drowsiness
- Headache
- Coughing
Midazolam serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe difficulty breathing
The following Midazolam side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Less common
Aggressiveness
agitation
choking
confusion
decreased awareness or responsiveness
decreased urine output
difficulty walking, speaking, or writing
discouragement
dizziness
feeling sad or empty
headache
irritability
lack of appetite
loss of bladder or bowel control
loss of consciousness
loss of interest or pleasure
memory loss
muscle twitching
nightmares or unusually vivid dreams
rapid weight gain
seizures
severe sleepiness
strong urge to urinate
swelling of the face, ankles, or hands
thirst
trouble concentrating
trouble sleeping
trouble breathing
unable to speak
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Lack of coordination
relaxed and calm feeling
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
Rare
Muscle stiffness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Midazolam
Pros
- Works within minutes to help you relax and feel calm before a medical procedure
- Available as an injection and an oral syrup
- Can be used in young children for sedation before a procedure
Cons
- Risk of severe breathing problems so it should only be used in a healthcare facility
- Can cause hangover effect and raise the risk of falls
- Not safe to use late in pregnancy
Pharmacist tips for Midazolam
- Because of the risk of severe breathing problems, midazolam oral syrup and injections should only be given by a trained healthcare provider right before a procedure or to treat a long-lasting seizure. You won't be able to use this on your own.
- You might feel really drowsy after your procedure, and the effects of midazolam could last for several hours. If you're going home right after your procedure, make sure you have a ride and someone who can take care of you.
- Many medications can interact with midazolam, especially ones that can make you dizzy or drowsy like other benzodiazepines or opioids. Don't take any additional medications unless your healthcare provider says it's okay.
- Interestingly, some people have experienced agitation and uncontrollable muscle movements (e.g., tremor) after taking midazolam. Your healthcare provider will monitor you for any of these side effects.
- Tell your provider if you're breastfeeding, since midazolam can pass into breast milk and cause drowsiness and poor feeding in babies. Your healthcare provider might recommend that you pump and throw away your breastmilk for at least 4 to 8 hours after receiving midazolam to reduce exposure to your baby.
Common questions about Midazolam
Yes, midazolam belongs to a class of medications called benzodiazepines. These medications help slow down activity in the brain and are used for many different conditions. Midazolam injection and oral syrup are only FDA approved to cause sedation before medical procedures and to treat seizures.
Midazolam will make you feel relaxed and drowsy. It might also cause some temporary memory loss. So, even if you're awake during your procedure, you might not remember what happened after the medication wears off.
Midazolam is available as a nasal spray (Nayzilam) and intramuscular (IM) injection (Seizalam) for the treatment of seizures. It helps slow down activity in the brain to help stop seizures. Nayzilam is FDA approved to treat seizure attacks, whereas Seizalam is approved to treat long-lasting seizures. Ask your healthcare provider if you have more questions about midazolam and how it treats seizures.
Midazolam typically lasts in your system for a few hours. When used before procedures, you should recover within 2 hours. But, it could take up to 6 hours or longer, and other medications used for sedation might make the effects last longer. Some people will experience a hangover effect from anesthesia for up to a full day after surgery. Plan your day accordingly so you don't have to drive, bike, or operate machinery until the effects have worn off.
It's best to avoid alcohol after taking midazolam. Alcohol has many of the same side effects as midazolam, such as dizziness and drowsiness. This can raise your risk of falls and might slow down your recovery process. The combination could also lead to life-threatening breathing problems.
Yes. Midazolam is available as an oral syrup that can be used for sedation before medical procedures. This form is especially helpful for children.
Let your provider know if you're pregnant before any procedure. Midazolam might harm your unborn baby. When it's used during late pregnancy, it could cause your baby to experience breathing problems and/or withdrawal symptoms like tremors and feeding difficulty.
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Midazolam dosage
Bottle of syrup| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 118ml of 2mg/ml | 1 bottle | $33.59 | $33.59 |
Typical dosage for Midazolam
Midazolam is available as an intravenous (IV) injection, intramuscular (IM) injection, and oral syrup that's administered by a healthcare provider.
The dose depends on your weight, dosage form you're using, and the reason you're taking it (e.g., type of medical procedure, long-lasting seizure).
Interactions between Midazolam and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Amprenavir
- Atazanavir
- Boceprevir
- Cobicistat
- Darunavir
- Delavirdine
- Flumazenil
- Fosamprenavir
- Indinavir
- Itraconazole
- Lopinavir
- Nelfinavir
- Saquinavir
- Telaprevir
- Tipranavir
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Alprazolam
- Amobarbital
- Anileridine
- Aprobarbital
- Baclofen
- Benzhydrocodone
- Bromazepam
- Bromopride
- Buprenorphine
- Buspirone
- Butabarbital
- Butalbital
- Butorphanol
- Calcifediol
- Calcium Oxybate
- Cannabidiol
- Carbinoxamine
- Carisoprodol
- Ceritinib
- Cetirizine
- Chloral Hydrate
- Chlordiazepoxide
- Chlorpromazine
- Chlorzoxazone
- Ciprofloxacin
- Clarithromycin
- Clobazam
- Clonazepam
- Clorazepate
- Codeine
- Conivaptan
- Cyclobenzaprine
- Dantrolene
- Dexmedetomidine
- Dezocine
- Diacetylmorphine
- Diazepam
- Difenoxin
- Dihydrocodeine
- Diphenhydramine
- Diphenoxylate
- Doxylamine
- Dronedarone
- Duvelisib
- Esketamine
- Estazolam
- Eszopiclone
- Ethchlorvynol
- Ethylmorphine
- Fentanyl
- Flibanserin
- Flunitrazepam
- Flurazepam
- Fosnetupitant
- Fospropofol
- Gabapentin
- Gabapentin Enacarbil
- Halazepam
- Hydrocodone
- Hydromorphone
- Hydroxyzine
- Idelalisib
- Imatinib
- Isavuconazonium Sulfate
- Ivosidenib
- Ketamine
- Ketazolam
- Ketobemidone
- Larotrectinib
- Lefamulin
- Lemborexant
- Letermovir
- Levocetirizine
- Levorphanol
- Lofexidine
- Lorazepam
- Lorlatinib
- Loxapine
- Lumacaftor
- Magnesium Oxybate
- Meclizine
- Meperidine
- Mephenesin
- Mephobarbital
- Meprobamate
- Meptazinol
- Metaxalone
- Methadone
- Methocarbamol
- Methohexital
- Methotrimeprazine
- Metoclopramide
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nefazodone
- Netupitant
- Nicomorphine
- Nilotinib
- Nitrazepam
- Opium
- Opium Alkaloids
- Orlistat
- Orphenadrine
- Oxazepam
- Oxycodone
- Oxymorphone
- Papaveretum
- Paregoric
- Pentazocine
- Pentobarbital
- Perampanel
- Periciazine
- Phenobarbital
- Piritramide
- Posaconazole
- Potassium Oxybate
- Prazepam
- Pregabalin
- Primidone
- Promethazine
- Propofol
- Quazepam
- Ramelteon
- Remifentanil
- Remimazolam
- Ribociclib
- Scopolamine
- Secobarbital
- Sodium Oxybate
- Sufentanil
- Tapentadol
- Temazepam
- Thiopental
- Thioridazine
- Tilidine
- Tizanidine
- Topiramate
- Tramadol
- Trazodone
- Triazolam
- Zaleplon
- Zolpidem
- Zopiclone
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aprepitant
- Armodafinil
- Carbamazepine
- Cimetidine
- Crizotinib
- Cyclosporine
- Dalfopristin
- Diltiazem
- Echinacea
- Erythromycin
- Fluconazole
- Fluvoxamine
- Fosaprepitant
- Fosphenytoin
- Ginkgo Biloba
- Goldenseal
- Halothane
- Laropiprant
- Mitotane
- Phenytoin
- Quinupristin
- Rifapentine
- Roxithromycin
- St John's Wort
- Telithromycin
- Theophylline
- Verapamil
- Voriconazole
How much does Midazolam cost?
$33.59
Midazolam contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Midazolam will not be safe for you to take.
- Acute narrow-angle glaucoma
- Allergy to cherries (oral syrup)
What are alternatives to Midazolam?
Midazolam images
