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All about: Midazolam

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Generic Name: Midazolam Injection (meh-DAZE-oh-lam)
Brand Name: Generic only. No brands available.

Midazolam may cause severe breathing problems (eg, respiratory depression, respiratory arrest), especially when used for sedation in noncritical care settings. Respiratory depression and respiratory arrest could result in brain damage or death if not treated properly. Midazolam should only be used under appropriate close medical supervision.

Do not give Midazolam by rapid intravenous (IV) injection to newborn infants (neonates). Severe low blood pressure and seizures have occurred in neonates when given Midazolam by rapid IV injection, especially when given at the same time as fentanyl.

Midazolam is used for:

Reducing anxiety or producing drowsiness or anesthesia before certain medical procedures or surgery. It may also be given continuously to maintain sedation or anesthesia in certain patients. It may also be used for other conditions as determined by your doctor.

Midazolam is a benzodiazepine. It works in the central nervous system (brain) to cause sleepiness, muscle relaxation, and short-term memory loss, and to reduce anxiety.

Do NOT use Midazolam if:

  • you are allergic to any ingredient in Midazolam
  • you have acute narrow-angle glaucoma, severe mental problems (eg, psychosis), or severe liver disease
  • you have alcohol intoxication with abnormal vital signs
  • you are taking delavirdine, efavirenz, an HIV protease inhibitor (eg, ritonavir), or sodium oxybate (GHB)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Midazolam :

Some medical conditions may interact with Midazolam . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have breathing problems (eg, COPD); open-angle glaucoma; heart, liver, or kidney problems; the blood disease porphyria; severe depression; or a history of drug abuse or dependence; or if you have used alcohol recently

Some MEDICINES MAY INTERACT with Midazolam . Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Carbamazepine, rifampin, or St. John's wort because the effectiveness of Midazolam may be decreased
  • Azole antifungals (eg, itraconazole), barbiturates (eg, phenobarbital), clozapine, delavirdine, diltiazem, disulfiram, efavirenz, grapefruit juice, HIV protease inhibitors (eg, ritonavir), ketolides (eg, telithromycin), macrolides (eg, erythromycin), narcotic pain medicines (eg, codeine), nefazodone, omeprazole, sodium oxybate (GHB), valproic acid, or verapamil and its derivatives because serious side effects, such as low blood pressure, breathing problems, and excessive sedation, may occur
  • Hydantoins because side effects may be increased by Midazolam

This may not be a complete list of all interactions that may occur. Ask your health care provider if Midazolam may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Midazolam :

Use Midazolam as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Midazolam is usually administered as an injection at your doctor's office, clinic, or hospital. Ask your doctor or pharmacist any questions that you may have about Midazolam .
  • If Midazolam contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
  • If you miss a dose of Midazolam , contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Midazolam .

Important safety information:

  • Midazolam may cause drowsiness or dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until the effects of Midazolam have disappeared or until the day after you receive Midazolam , whichever is longer. Using Midazolam alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
  • Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while using Midazolam . Midazolam will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
  • Midazolam can cause partial or complete memory loss for several hours.
  • Use Midazolam with caution in the ELDERLY because they may be more sensitive to its effects.
  • Caution is advised when using this medicine in CHILDREN because they may be more sensitive to its effects.
  • PREGNANCY and BREAST-FEEDING: Midazolam has been shown to cause harm to the fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Midazolam during pregnancy. Midazolam is excreted in breast milk. If you are or will be breast-feeding while you are using Midazolam , check with your doctor or pharmacist to discuss the risks to your baby.

When used for long periods of time or at high doses, some people develop a need to continue taking Midazolam . This is known as DEPENDENCE or addiction.

If you use Midazolam for long periods of time or at high doses and suddenly stop taking Midazolam , you may experience WITHDRAWAL symptoms including fast heartbeat, hallucinations, muscle cramps, seizures, stomach cramps, sweating, tremor, and vomiting.

Possible side effects of Midazolam :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; changes in blood pressure, breathing, and heartbeats; coughing; dizziness; drowsiness; dry mouth; headache; hiccups; low blood pressure (children); nausea; pain during injection; pain, redness, or tenderness at the injection site; short-term memory loss; slurred speech; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; chest pain; combativeness; irregular breathing patterns; pain, swelling, or redness at the injection site; slow or difficult breathing; unusual or involuntary muscle movements or muscle tremor.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include clumsiness; confusion; deep sleep; loss of consciousness; sleepiness; slow reflexes.

Proper storage of Midazolam :

Midazolam is usually handled and stored by a health care provider. If you are using Midazolam at home, store Midazolam as directed by your pharmacist or health care provider. Store away from heat, moisture, and light. Keep Midazolam out of the reach of children and away from pets.

General information:

  • If you have any questions about Midazolam , please talk with your doctor, pharmacist, or other health care provider.
  • Midazolam is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Midazolam . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: September 5, 2007
Database Edition
Copyright © 2007 Wolters Kluwer Health, Inc.

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