midazolam (injection)

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Pronunciation: mi DAZ oh lam

Brand: Versed

What is the most important information I should know about midazolam?

You should not receive this medication if you have narrow-angle glaucoma.

Using midazolam with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Do not drink alcohol shortly after receiving midazolam. This medication can increase the effects of alcohol, which could be dangerous.

In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this medicine.

What is midazolam?

Midazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen) sedative.

Midazolam injection is used to sedate a person who is having a minor surgery, dental work, or other medical procedure.

Midazolam injection is also used to sedate a patient who is under critical care and needs a mechanical ventilator (breathing machine).

Midazolam injection may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before receiving midazolam?

You should not be treated with midazolam injection if you are allergic to it, or if you have:

  • narrow-angle glaucoma.

To make sure midazolam is safe for you, tell your doctor if you have:

  • open-angle glaucoma;
  • asthma or other breathing disorder;
  • kidney or liver disease;
  • congestive heart failure;
  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
  • if you are dehydrated; or
  • if you have recently used alcohol, sedatives, tranquilizers, or narcotic (opioid) medications.

Midazolam can cause birth defects in an unborn baby, and generally should not be used during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant.

Sedatives used during surgery may affect brain development in a child under 3, or an unborn baby whose mother receives this medicine during late pregnancy. These effects may be more likely when a sedative is used for 3 hours or longer, or used for repeated procedures. Effects on brain development could cause learning or behavior problems later in life.

Negative brain effects from sedatives have been seen in animal studies. However, studies in human children receiving single short uses of this medicine have not shown a likely effect on behavior or learning. More research is needed.

In some cases, your doctor may decide to postpone a surgery based on these risks. Treatment may not be delayed in the case of life-threatening conditions, medical emergencies, or surgery needed to correct certain birth defects.

Ask your doctor for information about all medicines that will be used during your surgery, and how long the surgery will last.

Midazolam can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is midazolam injection given?

Midazolam is injected into a muscle, or into a vein through an IV. You will receive this injection in a medical, dental, or surgical setting.

Midazolam is usually given as a single dose just before a surgery or medical procedure. For mechanical ventilation, midazolam is given using a continuous infusion that keeps the patient sedated around the clock.

After treatment with midazolam injection, you will be watched to make sure the medication 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.

When midazolam is discontinued after long-term use, you may have withdrawal symptoms. The most common withdrawal symptoms are hallucinations, tremors, sweating, muscle cramps, stomach pain, and vomiting. You may also have a seizure (convulsions).

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?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving midazolam?

Do not drink alcohol shortly after receiving midazolam. Dangerous side effects or death can occur.

Midazolam injection can cause extreme drowsiness that may last for several 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.

What are the possible side effects of midazolam?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

  • wheezing, trouble breathing, weak or shallow breathing;
  • slow heart rate;
  • a light-headed feeling, like you might pass out;
  • tremors, uncontrolled muscle movements;
  • restlessness, feeling agitated;
  • a seizure (convulsions); or
  • confusion, hallucinations, loss of coordination, muscle weakness.

The sedative effects of midazolam may last longer in older adults. Accidental falls are common in elderly patients who use benzodiazepines.

Common side effects may include:

  • drowsiness, dizziness, confusion;
  • pain, redness, or swelling where the medicine was injected;
  • headache, blurred vision;
  • cough, hiccups;
  • nausea, vomiting; or
  • amnesia or forgetfulness after your procedure.

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.

What other drugs will affect midazolam?

Shortly after you are treated with this medicine, 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.

Tell your doctor about all your current medicines, especially:

  • any other benzodiazepines (such as alprazolam, diazepam, Valium, Xanax, and others);
  • antibiotic or antifungal medicine;
  • heart or blood pressure medicine; or
  • HIV or AIDS medication.

This list is not complete. Other drugs may interact with midazolam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your doctor or pharmacist can provide more information about midazolam injection.

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.

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