Midazolam
Benzodiazepine used for anesthesia and procedural sedation / From Wikipedia, the free encyclopedia
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Midazolam, sold under the brand name Versed among others, is a benzodiazepine medication used for anesthesia and procedural sedation, and to treat severe agitation.[10] It induces sleepiness, decreases anxiety, and causes anterograde amnesia.[10]
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Pronunciation | /mɪˈdæzəlæm/ |
Trade names | 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%)[8][9] intramuscular 90%+ |
Protein binding | 97% |
Metabolism | Liver: CYP3A3, CYP3A4, CYP3A5 |
Onset of action | Within 5 min (IV), 15 min (IM), 20 min (oral)[10] |
Elimination half-life | 1.5–2.5 hours[11] |
Duration of action | 1 to 6 hrs[10] |
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.[10] It is also useful for the treatment of prolonged (lasting over 5 minutes) seizures.[12] Midazolam can be given by mouth, intravenously, by injection into a muscle, by spraying into the nose, or through the cheek.[10][12] When given intravenously, it typically begins working within five minutes; when injected into a muscle, it can take fifteen minutes to begin working.[10] Effects last between one and six hours.
Side effects can include a decrease in efforts to breathe, low blood pressure, and sleepiness.[10] Tolerance to its effects and withdrawal syndrome may occur following long-term use.[13] Paradoxical effects, such as increased activity, can occur especially in children and older people.[13] There is evidence of risk when used during pregnancy but no evidence of harm with a single dose during breastfeeding.[14][15] 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.[16] It is on the World Health Organization's List of Essential Medicines.[17] Midazolam is available as a generic medication.[14] In many countries, it is a controlled substance.[10]