Midazolam Injection BP (DBL)

Generic Name: Midazolam hydrochloride
Product Name: Midazolam Injection BP (DBL)

Indication

Conscious sedation
Induction of anaesthesia
Sedation in intensive care units
Pre-medication
Acute behavioural disturbance

Action

Benzodiazepines potentiate the inhibitory effects of gamma aminobutyric acid (GABA) throughout the CNS, resulting in anxiolytic, sedative hypnotic, muscle relaxant and antiepileptic effects

Dose advice

Individualize dose and administer slowly (2.5mg over 10 seconds)
Decrease dose in elderly or debilitated patients, hepatic or renal disease
Adult:
Conscious sedation: usual dose IV 2.5mg or 0.05mg/kg. Some may respond to 1mg. Give further 1mg doses as needed; doses >5mg rarely needed
Induction of anaesthesia: IV 0.015-0.35mg/kg
Sedation in intensive care units: IV 0.03-0.2mg/kg/hour
Premedication: IM 0.07-0.08mg/kg 1 hour before procedure. Elderly IM 0.02-0.05mg/kg
Acute behavioural disturbance: IM 5mg or 0.1mg/kg in patients <50kg
Child:
Induction of anaesthesia: IV 0.015-0.5mg/kg
Sedation in intensive care units: IV 0.03-0.3mg/kg/hour
Premedication: oral 0.4-0.6mg/kg (maximum 15mg) or intranasal 0.2-0.4mg/kg (maximum 5mg)

Schedule

Common side effects

Drowsiness
Over-sedation
Light-headedness
Memory loss
Ataxia
Slurred speech

Uncommon side effects

Headache
Vertigo
Hypotension
Disorientation
Confusion
Paradoxical excitation
Euphoria
Aggression and hostility
Anxiety
Decreased libido
Anterograde amnesia
Pain and thrombophlebitis with IV injection
Respiratory arrest with IV use