Injection, Generic Name: Midazolam HCl , Manufacturer: Incepta Pharmaceuticals Ltd.
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Indications
Midazolam is used to treat insomnia for a short period of time.
Before surgical or diagnostic operations, sedation is used as a premedication.
Pharmacology
The inhibitory neurotransmitter gamma-aminobutyric acid (GABA), which is one of the key inhibitory neurotransmitters in the central nervous system, mediates the activities of benzodiazepines like midazolam. Benzodiazepines increase GABA activity, causing sedation, relaxation of skeletal muscles, and induction of sleep, anesthesia, and forgetfulness. Benzodiazepines bind to the benzodiazepine site on GABA-A receptors, increasing the frequency of chloride channel opening and so potentiating the effects of GABA. These receptors have been found in a variety of human tissues, including the heart and skeletal muscle, but they appear to be concentrated in the central nervous system.
Dosage & Administration
Oral dosage:
For adults: 7.5-15 mg daily.
In elderly and debilitated patients: The recommended dose is 7.5 mg.
In premedication: 15 mg of Midazolam should be given 30-60 minutes before the procedure.
Intravenous administration:
Endoscopic or Cardiovascular Procedures: In healthy adults, the initial dose is approximately 2.5 mg. In cases of severe illness and in elderly patients, the initial dose must be reduced to 1 to 1.5 mg.
Induction of Anesthesia: The dose is 10-15 mg.
Intramuscular administration:
Adult: 0.07-0.1 mg/kg body weight. The usual dose is about 5 mg.
Children: 0.15-0.20 mg/kg
Elderly and debilitated patients: 0.025-0.05 mg/kg
Rectal administration in children:
For preoperative sedation: Rectal administration of the ampoule solution (0.35-0.45 mg/kg) 20-30 min. before induction of general anesthesia.
Interactions
Neuroleptics, tranquilizers, antidepressants, sleep-inducing medications, analgesics, anesthetics, antipsychotics, anxiolytics, antiepileptic drugs, and sedative antihistamines can all be enhanced by midazolam.
Contraindications
Patients with severe respiratory insufficiency, severe hepatic insufficiency, myasthenia gravis, sleep apnea syndrome, or known hypersensitivity to benzodiazepines or any component of the medication should not be given midazolam.
Side Effects
Drowsiness throughout the day, disorientation, weariness, headache, and muscle weakness may occur at the start of therapy, although these side effects normally fade away with repeated dosing. Abnormalities in vital signs have been observed following the parenteral (IV or IM) injection of Midazolam, including respiratory depression, apnea, blood pressure variations, and pulse rate variations.
Pregnancy
Unless there is no other option, midazolam should be avoided during pregnancy. Because midazolam travels through breast milk, it should not be given to nursing women.
Precautions
Midazolam IV should be administered very slowly.
Storage Conditions
Protect from light and moisture, and store in a cool and dry place. Keep out of the reach of children.
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