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Midazolam

Midazolam
Midazolam.svg
Midazolam ball-and-stick model.png
Clinical data
Pronunciation /mɪˈdæzəlæm/
Trade names Dormicum, Hypnovel, Versed
AHFS/Drugs.com Monograph
MedlinePlus a609003
Pregnancy
category
  • AU: C
  • US: D (Evidence of risk)
Routes of
administration
by mouth, IM, IV, parenteral
ATC code
Legal status
Legal status
Pharmacokinetic data
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)
Biological half-life 1.5-2.5 hours
Duration of action 1 to 6 hrs
Excretion Kidney
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
ECHA InfoCard 100.056.140
Chemical and physical data
Formula C18H13ClFN3
Molar mass 325.78
3D model (Jmol)
  

Midazolam, marketed under the trade name Versed, among others, is a medication used for anesthesia, procedural sedation, trouble sleeping, and severe agitation. It works by making people sleepy, decreasing anxiety, and causing a loss of ability to create new memories. It is also useful for the treatment of seizures. Midazolam can be given by mouth, intravenously, by injection into a muscle, sprayed into the nose, or in the cheek. When given intravenously, it begins working, typically, within five minutes; when injected into a muscle, it can take fifteen minutes to begin working. Effects last for 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. It is of the benzodiazepine class and works through the GABA neurotransmitter.

Midazolam first came into use in 1976. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Midazolam is available as a generic medication and is not very expensive. The wholesale cost in the developing world of a vial is about 0.35 USD. In many countries, it is a controlled substance.


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