Generic Name: midazolam (oral) (mye DAZ oh lam)
Brand Name: Versed
What is midazolam?
Midazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen) sedative.
Midazolam is used to sedate a person who is having a minor surgery, dental work, or other medical procedure.
Midazolam may also be used for purposes not listed in this medication guide.
What is the most important information I should know about midazolam?
Midazolam can slow or stop your breathing, especially if you have recently used a narcotic (opioid) medication. Midazolam is given in a hospital, dentist office, or other clinic setting where your vital signs can be watched closely.
You should not take midazolam if you have narrow-angle glaucoma, if you are allergic to cherries, or if you are allergic to midazolam or similar medicines (Valium, Xanax, Ativan, and others).
Do not drink alcohol for at least 24 hours after taking midazolam.
What should I discuss with my healthcare provider before taking midazolam?
You should not take this medicine if:
you have narrow-angle glaucoma;
you are allergic to cherries; or
you are allergic to midazolam or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).
To make sure midazolam is safe for you, tell your doctor if you have:
asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
kidney or liver disease;
congestive heart failure; or
if you also use a narcotic (opioid) medication.
Midazolam can cause birth defects in an unborn baby, and generally should not be used during pregnancy. Tell your doctor if you are pregnant.
Midazolam can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I take midazolam?
Midazolam can slow or stop your breathing, especially if you have recently used a narcotic (opioid) medication. Midazolam should be used only in a hospital, dentist office, or other clinic setting where any serious side effects can be quickly treated.
Midazolam is usually given as a single dose just before your surgery or procedure.
After you take midazolam, you will be watched closely to make sure the medicine is working and does not cause harmful side effects.
Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are in surgery.
Midazolam can make you very drowsy, dizzy, or light-headed. These effects may last longer in older adults. Use caution to avoid falling or accidental injury after you have received midazolam injection. You may need help getting out of bed for at least the first 8 hours.
What happens if I miss a dose?
Because you will receive midazolam in a clinical setting, you are not likely to miss a dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of midazolam can be fatal.
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid while taking midazolam?
Do not drink alcohol for at least 24 hours after taking midazolam. This medication can increase the effects of alcohol, which could be dangerous.
Grapefruit and grapefruit juice may interact with midazolam and lead to potentially dangerous effects. Avoid the use of grapefruit products while taking midazolam.
Midazolam injection can cause extreme drowsiness that may last for 24 hours after you have received the medication. Older adults may feel sleepy for even longer.
Avoid driving or doing anything that requires you to be awake and alert until the effects of this medicine have worn off completely.
Midazolam side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers right away if you have:
cough, wheezing, trouble breathing, weak or shallow breathing;
slow heart rate;
a light-headed feeling, like you might pass out;
agitation, hostility, tremors; or
confusion, hallucinations, unusual thoughts or behavior.
The sedative effects of midazolam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking midazolam.
Common side effects may include:
amnesia or forgetfulness after your procedure;
runny nose, sneezing; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Midazolam dosing information
Usual Adult Dose for Light Sedation:
10 to 20 mg one time before procedure (IM or IV is preferred).
1 to 2.5 mg IV over 2 to 3 minutes before procedure. Wait an additional 2 or more minutes to fully evaluate the sedative effect. If additional titration is necessary, it should be given at a rate of no more than 1 mg over 2 minutes, waiting an additional 2 or more minutes each time to fully evaluate the sedative effect. Total doses greater than 5 mg are not usually necessary.
0.07 to 0.08 mg/kg 30 to 60 minutes prior to surgery. Reduce dose in patients with COPD, high risk patients, and when narcotics or other CNS depressants are used. Maximum dose 10 mg.
Usual Adult Dose for Light Anesthesia:
Initial dose: 2 mg IV once at a rate not to exceed 1 mg/min immediately before the procedure. Additional doses of 0.5 to 2 mg may be administered after 2 minutes to achieve desired level of sedation. Most patients achieve adequate sedation with a total dose less than 5 mg.
Maintenance dose: Generally does not exceed 25% of the dose initially required to achieve sedation.
Usual Adult Dose for ICU Agitation:
Initial dose: 0.01 to 0.08 mg/kg (usually 1 to 5 mg) IV over 2 to 3 minutes, every 5 to 15 minutes to control acute agitation.
Maintenance dose: 0.02 to 0.2 mg/kg/hour by continuous infusion. The patient should be assessed regularly and the infusion rate adjusted to maintain the desired level of sedation. The minimum effective rate is recommended. Lower infusion rates are required in patients also receiving opioid analgesics.
Usual Geriatric Dose for Light Sedation:
1 to 1.5 mg IV over 2 to 3 minutes before procedure. Wait an additional 2 or more minutes to fully evaluate the sedative effect. If additional titration is necessary, it should be given at a rate of no more than 1 mg over 2 minutes, waiting an additional 2 or more minutes each time to fully evaluate the sedative effect. Total doses greater than 3.5 mg are not usually necessary.
0.02 to 0.05 mg/kg IM 30 to 60 minutes prior to surgery.
Usual doses are 1 to 3 mg. Some patients may respond to as little as 1 mg.
If concomitant CNS depressant premedications are used in these patients, they will require at least 50% less midazolam than healthy young unpremedicated patients.
What other drugs will affect midazolam?
Shortly after you take midazolam, taking other drugs that make you sleepy or slow your breathing can cause dangerous side effects. Tell your doctor if you regularly use a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.
Many drugs can interact with midazolam. Not all possible interactions are listed here. Tell your doctor about all your current medicines, especially:
heart or blood pressure medicine;
antiviral medicine to treat hepatitis C or HIV/AIDS;
seizure medication; or
This list is not complete and many other drugs can interact with midazolam. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
More about midazolam
- Midazolam syrup
- Midazolam injection
- Midazolam (Advanced Reading)
- Midazolam Injection (Advanced Reading)
- Other brands: Versed
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about midazolam.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01.
Last reviewed: November 29, 2016
Date modified: January 10, 2017