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Midazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen) sedative.
Midazolam is used to sedate a person who is having a minor surgery, dental work, or other medical procedure.
Midazolam may also be used for purposes not listed in this medication guide.
Midazolam can slow or stop your breathing, especially if you have recently used a narcotic (opioid) medication. Midazolam is given in a hospital, dentist office, or other clinic setting where your vital signs can be watched closely.
You should not take midazolam if you have narrow-angle glaucoma, if you are allergic to cherries, or if you are allergic to midazolam or similar medicines (Valium, Xanax, Ativan, and others).
Do not drink alcohol for at least 24 hours after taking midazolam.
You should not take midazolam if:
you have narrow-angle glaucoma;
you are allergic to cherries; or
you are allergic to midazolam or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).
To make sure midazolam is safe for you, tell your doctor if you have:
open-angle glaucoma;
asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
kidney or liver disease;
congestive heart failure; or
if you also use a narcotic (opioid) medication.
Midazolam can cause birth defects in an unborn baby, and generally should not be used during pregnancy. Tell your doctor if you are pregnant.
Midazolam can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Midazolam can slow or stop your breathing, especially if you have recently used a narcotic (opioid) medication. Midazolam should be used only in a hospital, dentist office, or other clinic setting where any serious side effects can be quickly treated.
Midazolam is usually given as a single dose just before your surgery or procedure.
After you take midazolam, you will be watched closely to make sure the medicine is working and does not cause harmful side effects.
Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are in surgery.
Midazolam can make you very drowsy, dizzy, or light-headed. These effects may last longer in older adults. Use caution to avoid falling or accidental injury after you have received midazolam injection. You may need help getting out of bed for at least the first 8 hours.
Because you will receive midazolam in a clinical setting, you are not likely to miss a dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of midazolam can be fatal.
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
Do not drink alcohol for at least 24 hours after taking midazolam. This medication can increase the effects of alcohol, which could be dangerous.
Grapefruit and grapefruit juice may interact with midazolam and lead to potentially dangerous effects. Avoid the use of grapefruit products while taking midazolam.
Midazolam injection can cause extreme drowsiness that may last for 24 hours after you have received the medication. Older adults may feel sleepy for even longer.
Avoid driving or doing anything that requires you to be awake and alert until the effects of midazolam have worn off completely.
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers right away if you have:
cough, wheezing, trouble breathing, weak or shallow breathing;
slow heart rate;
a light-headed feeling, like you might pass out;
agitation, hostility, tremors; or
confusion, hallucinations, unusual thoughts or behavior.
The sedative effects of midazolam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking midazolam.
Common side effects may include:
amnesia or forgetfulness after your procedure;
drowsiness, dizziness;
nausea, vomiting;
runny nose, sneezing; or
blurred vision.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Shortly after you take midazolam, taking other drugs that make you sleepy or slow your breathing can cause dangerous side effects. Tell your doctor if you regularly use a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.
Many drugs can interact with midazolam. Not all possible interactions are listed here. Tell your doctor about all your current medicines, especially:
antifungal medicine;
an antibiotic;
an antidepressant;
heart or blood pressure medicine;
antiviral medicine to treat hepatitis C or HIV/AIDS;
seizure medication; or
tuberculosis medication.
This list is not complete and many other drugs can interact with midazolam. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Midazolam Hydrochloride (www.drugs.com/mtm/midazolam.html).
Commonly reported side effects of midazolam include: apnea and bradypnea. Other side effects include: variable blood pressure. See below for a comprehensive list of adverse effects.
Applies to midazolam: injection solution
Other dosage forms:
Injection route (Solution)
Midazolam has been associated with respiratory depression and respiratory arrest, especially when used for sedation in noncritical care settings. Use only in settings that can provide for continuous monitoring of respiratory and cardiac function. The initial dose and all subsequent doses should always be titrated slowly. Midazolam injection should not be administered by rapid injection in the neonatal population as severe hypotension and seizures have been reported.
Along with its needed effects, midazolam 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 while taking midazolam:
Less common
Some side effects of midazolam 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
Rare
Applies to midazolam: compounding powder, injectable solution, intravenous solution, nasal spray, oral syrup
The most commonly reported side effects with oral formulations include emesis and nausea. Decreased tidal volume/respiratory rate and apnea were most commonly reported with parenteral formulations.
Oral:
Very common (10% or more): Respiratory adverse events (up to 11%)
Common (1% to 10%): Respiratory depression, hypoxia, laryngospasm, upper airway obstruction, rhonchi, congestion
Uncommon (0.1% to 1%): Sneezing/rhinorrhea
Frequency not reported: Apnea, hypercarbia, desaturation, stridor, hiccough
Parenteral:
Very common (10% or more): Decreased tidal volume/respiratory rate (up to 23.3%), apnea (up to 15.4%)
Common (1% to 10%): Hiccoughs, coughing, desaturation
Very rare (less than 0.01%): Dyspnea, hiccup, laryngospasm, respiratory arrest
Frequency not reported: Respiratory depression
Postmarketing reports: Bronchospasm, hyperventilation, wheezing, shallow respirations, airway obstruction, tachypnea, dysphonia, yawning, continued phonation
Respiratory adverse events included hypoxia, laryngospasm, rhonchi, coughing, respiratory depression, airway obstruction, upper airway congestion, and shallow respirations; these side effects occurred more frequently at higher doses.
Decreased tidal volume/respiratory rate occurred in 23.3% of patients given IV formulations and in 10.8% of patients given IM formulations.
Apnea occurred in 15.4% of patients given IV formulations.
Oral:
Very common (10% or more): Emesis/vomiting (up to 11%)
Common (1% to 10%): Nausea
Frequency not reported: Gagging, salivation
Parenteral:
Common (1% to 10%): Nausea, vomiting
Very rare (less than 0.01%): Constipation, dry mouth
Postmarketing reports: Acid taste, excessive salivation, retching, toothache
Oral:
Common (1% to 10%): Sedation/prolonged sedation, somnolence, depressed levels of consciousness
Frequency not reported: Drooling, dizziness, ataxia, vertigo, dysarthria, loss of balance
Parenteral:
Common (1% to 10%): Headache, oversedation, drowsiness, seizure-like activity
Very rare (less than 0.01%): Movement disorder, ataxia, dizziness, seizure, anterograde amnesia
Frequency not reported: Involuntary movements, hyperactivity, decreased alertness, somnolence, prolonged/postoperative sedation, convulsions/drug withdrawal convulsions, feeling faint, tonic/clonic movements and muscle tremor
Postmarketing reports: Vasovagal episode, retrograde amnesia, grogginess, athetoid movements, lethargy, slurred speech, paresthesia, loss of balance, lightheadedness, feeling of burning, emergence delirium or agitation
Oral:
Common (1% to 10%): Bradycardia, bigeminy
Frequency not reported: Increased heart rate, cardiac arrest, heart failure, decreased systolic and diastolic blood pressure
Parenteral:
Common (1% to 10%): Hypotension
Very rare (less than 0.01%): Bradycardia, cardiac arrest, vasodilation
Frequency not reported: Thrombophlebitis, thrombosis, variations in blood pressure and pulse rate
Postmarketing reports: Bigeminy, premature ventricular contractions, tachycardia, nodal rhythm, hematoma, cardiovascular collapse, cardiovascular reactions, severe cardiorespiratory adverse events
Parenteral:
Common (1% to 10%): IM injection site pain, IV site tenderness/pain during injection/redness/induration
Uncommon (0.1% to 1%): IM injection site induration/redness/muscle stiffness, IV site phlebitis
Frequency not reported: Injection site erythema, injection site pain
Postmarketing reports: Hive-like elevation at injection site, warmth or coldness at injection site
Oral:
Common (1% to 10%): Agitation
Frequency not reported: Dysphoria, disinhibition, excitation, aggression, mood swings, hallucinations, confusion, inappropriate/adverse behavior, behavioral/emotional disorders, euphonia, libido disorders, restlessness, irritability, delusions, anger eruptions, nightmares, psychosis, physical dependency, withdrawal symptoms, abuse, depression (existing, unobserved depression)
Parenteral:
Very rare (less than 0.01%): Aggression/aggressiveness, agitation, anger, hallucination, hostility, confusion/confusional state, euphoric mood/euphoria
Frequency not reported: Rage, excitement/paroxysmal excitement, abuse, physical drug dependence and withdrawal syndrome
Postmarketing reports: Argumentativeness, nervousness, anxiety, restlessness, sleep disturbance, insomnia, nightmares, dysphoria, irritability, tension, mood changes, dreaming during sleep
Oral:
Common (1% to 10%): Rash
Uncommon (0.1% to 1%): Pruritus and urticaria
Parenteral:
Frequency not reported: Angioedema
Postmarketing reports: Hives, rash, pruritus, skin reactions
Oral:
Frequency not reported: Diplopia, strabismus, blurred vision
Parenteral:
Common (1% to 10%): Nystagmus
Postmarketing reports: Blurred vision, diplopia, pinpoint pupils, visual disturbance, difficulty focusing eyes, cyclic movement of the eyelids
Oral:
Frequency not reported: Fatigue, falls
Parenteral:
Common (1% to 10%): Paradoxical reaction
Very rare (less than 0.01%): Fatigue, falls, assault/physical assault
Postmarketing reports: Prolonged emergence from anesthesia, blocked ears, chills, weakness, swelling, dreaming during emergence
Oral:
Frequency not reported: Hypersensitivity
Parenteral:
Frequency not reported: Hypersensitivity, anaphylactic shock
Postmarketing reports: Allergic reaction, anaphylactoid reactions
Oral:
Frequency not reported: Muscle weakness, fractures
Parenteral:
Frequency not reported: Fractures
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Midazolam Hydrochloride (www.drugs.com/mtm/midazolam.html).
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