Generic

Midazolam

Indications

Short-term treatment of insomnia. Benzodiazepines are only indicated when the disorder is severe, disabling or subjecting the individual to extreme distress. Sedation in premedication before surgical or diagnostic procedures

Pharmacology

The actions of benzodiazepines such as midazolam are mediated by the inhibitory neurotransmitter gammaaminobutyric acid (GABA), which is one of the major inhibitory neurotransmitters of the central nervous system. Benzodiazepines increase the activity of GABA, thereby producing sedation, skeletal muscle relaxation, and sleep, anesthesia, and amnesia. Benzodiazepine binds to the benzodiazepine site on GABAA receptors, potentiating the effects of GABA by increasing the frequency of chloride channel openings. These receptors have been identified in various body tissues, including heart and skeletal muscle, although they appear to be mainly present in the central nervous system.

Dosage & Administration

Oral dosage: For adults 7.5-15 mg daily. In elderly and debilitated patients, the recommended dose is 7.5 mg. In premedication, 15 mg of Midazolam should be given 30-60 minutes before the procedure.

Intravenous administration: Endoscopic or Cardiovascular procedures In healthy adults the initial dose is approximately 2.5 mg. In case of severe illness and in elderly patients, the initial dose must be reduced to 1 to 1.5 mg. Induction of anesthesia The dose is 10-15 mg i.v.

Intramuscular administration:

Adult: 0.07-0.1 mg/kg body weight i.m. Usual dose is about 5 mg

Children: 0.15-0.20 mg/kg

Elderly and debilitated patients: 0.025-0.05 mg/kg

Rectal administration in children: For preoperative sedation, rectal administration of ampoule solution (0.35-0.45 mg/kg) 20-30 min. before induction of general anesthesia.

Interaction

Midazolam may enhance the central sedative effect of neuroleptics, tranquilizers, antidepressants, hypnotics, analgesics, anesthetics, antipsychotics, anxiolytics, antipsychotics, epilepsy, and sedating antihistamines.

Contraindications

severe respiratory insufficiency, severe hepatic insufficiency; sleep apnea syndrome; children; use in patients with known hypersensitivity to benzodiazepines or to any component of the product; myasthenia gravis.

Side Effects

Drowsiness during the day, numbed emotions, reduced alertness, confusion, fatigue, headache, dizziness, muscle weakness, ataxia or double vision. These phenomena occur predominantly at the start of therapy and usually disappear with repeated administration.

Pregnancy & Lactation

Midazolam should be avoided during pregnancy unless a safer alternative is not available. Because midazolam passes into breast milk, this medicine should not be given to nursing mothers.

Precautions & Warnings

Intravenous midazolam must be very slow.

Therapeutic Class

Benzodiazepine hypnotics, Benzodiazepine sedatives

Storage Conditions

Store at temperature not exceeding 30 0C in a dry place. Protect from light.  Medicine keep out of

Pharmaceutical Name

Healthcare Pharmaceuticals Ltd.