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Midazolam

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Molecule Summary

Uses
Preoperative sedation, Induction of general anaesthesia
Therapy
General Anaesthesia
Side Effects
Sleepiness, Dizziness, Sneezing, Hiccups, Shallow breathing, Pain at the injection site
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Molecule Description

Midazolam is an anaesthetic medication used for maintaining unconsciousness or sleep during surgical procedures. It can be used to sedate patients in intensive care units (ICUs) and administer anaesthesia before surgery. It causes drowsiness, relieves anxiety, and prevents any memory of the surgical event.

Uses

  • As per CDSCO, Midazolam is used for the treatment of:
  • Preoperative sedation
  • Induction of general anaesthesia

Contraindications

When should one not use Midazolam

  • If you are allergic to Midazolam
  • If you have narrow-angle glaucoma (increased pressure in the eye)
  • If you have low blood pressure or shock-like condition

Side effects

Common side effects of this drug are:

  • Sleepiness
  • Dizziness
  • Sneezing
  • Hiccups
  • Shallow breathing
  • Pain at the injection site

Precautions and Warnings

Pregnancy

Pregnancy

No. Midazolam is not recommended during pregnancy as some research data has reported congenital abnormalities in babies whose mothers took benzodiazepines, including midazolam, in the first trimester. As a precaution, Midazolam should not be given to pregnant women unless necessary or in a life-threatening condition. If you are expecting to become pregnant or are pregnant, talk to your doctor before receiving the medicine.

Breast Feeding

Breast Feeding

Midazolam is not recommended if you are a nursing mother. Some data suggest that this medicine may excrete into breast milk and consequently harm the baby. Consult your doctor before receiving the medicine.

Driving

Driving

Administration of Midazolam decreases alertness, affects your vision, and makes you dizzy and lightheaded. If you experience these side effects after receiving the medicine, avoid driving.

Alcohol

Alcohol

Avoid alcohol consumption for at least 24 hours after being given Midazolam. Alcohol may increase the chances of severe side effects, including concentration difficulties, poor thinking, dizziness, increased sleepiness, etc.

Other General Warnings

Other General Warnings

Talk to your doctor if
  • You have an allergic reaction after receiving Midazolam.
  • You have hypoventilation or apnea.
  • You have low blood pressure.
  • You have a cough, breathing issues, or any other respiratory illness.
  • You experience severe side effects persistently.
  • You use other prescription medications or Ayurvedic/ herbal medicines, vitamins and other health supplements. These may interact with Midazolam.
  • You are an older adult over 60 years of age.
  • You are pregnant or breastfeeding. Talk to your doctor before use.
  • You have severe kidney or liver disease.
  • You have a history of drug abuse.

Mode of Action

How Does It Work?

Midazolam belongs to the benzodiazepines class of medications. It works by enhancing the inhibitory action of the GABA-A receptor, which is an inhibitory channel that decreases excess neuronal activity in the brain. As a result, it leads to central nervous system (CNS) depression and induces anaesthetic effects.

Interactions

Interactions with other medicines

  • Interaction of Midazolam with pain killers, such as morphine, oxycodone, fentanyl, hydrocodone, tramadol, and codeine, may lead to extreme sedation and drowsiness.
  • Midazolam should not be used concomitantly with monoamine oxidase inhibitors (MAOIs) like isocarboxazid, linezolid, methylene blue, selegiline, rasagiline, etc. as they can cause serious side effects like decreased breathing, low heart rate, etc.
  • Interaction with ketoconazole, fluconazole, and itraconazole increases the plasma concentrations of Midazolam.
  • Interaction with other benzodiazepines potentiates the anaesthetic effects of Midazolam.

Dosage

Overdose

Midazolam overdose may cause serious side effects like dizziness, chest tightness, breathing problems, terrible cough, respiratory difficulties, abnormal heartbeat, abnormally low blood pressure, and shock. If you experience these symptoms, seek emergency medical treatment.

Missed a Dose

There is little chance of missing Midazolam as healthcare professionals in a clinical setting give it.

Frequently Asked Questions (FAQs)

Midazolam is safe if given in the recommended doses and for the duration directed by your doctor.

You should avoid drinking alcohol for at least 24 hours after leaving the hospital or surgery centre.

The amount of time for which Midazolam remains effective is subject to many factors and varies from person to person.

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