Midazolam
Midazolam, sold under the brand name Dormicum and Versed among others, is a benzodiazepine medication used for anesthesia and procedural sedation, and to treat severe agitation. It induces sleepiness, decreases anxiety, and causes anterograde amnesia.
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| Pronunciation | /mɪˈdæzəlæm/ |
| Trade names | Dormicum, Hypnovel, Versed, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a609003 |
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| Routes of administration | By mouth, intramuscular, intravenous, buccal, intranasal |
| Drug class | Benzodiazepine |
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| Bioavailability | By mouth (variable, around 40%) intramuscular 90%+ |
| Protein binding | 97% |
| Metabolism | Liver 3A3, 3A4, 3A5 |
| Onset of action | Within 5 min (IV), 15 min (IM), 20 min (oral) |
| Elimination half-life | 1.5–2.5 hours |
| Duration of action | 1 to 6 hrs |
| Excretion | Kidney |
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| ECHA InfoCard | 100.056.140 |
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| Formula | C18H13ClFN3 |
| Molar mass | 325.77 g·mol−1 |
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The drug does not cause an individual to become unconscious, merely to be sedated. It is also useful for the treatment of prolonged (lasting over 5 minutes) seizures. Midazolam can be given by mouth, intravenously, by injection into a muscle, by spraying into the nose, or through the cheek. When given intravenously, it typically begins working within five minutes; when injected into a muscle, it can take fifteen minutes to begin working. Effects last between one and six hours.
Side effects can include a decrease in efforts to breathe, low blood pressure, and sleepiness. Tolerance to its effects and withdrawal syndrome may occur following long-term use. Paradoxical effects, such as increased activity, can occur especially in children and older people. There is evidence of risk when used during pregnancy but no evidence of harm with a single dose during breastfeeding. Like other benzodiazepines, it works by increasing the activity of the GABA neurotransmitter in the brain.
Midazolam was patented in 1974 and came into medical use in 1982. It is on the World Health Organization's List of Essential Medicines. Midazolam is available as a generic medication. In many countries, it is a controlled substance.