MIDAZOLAM

Standard Dosage Midazolam is a potent sedative agent that requires titration and slow administration. Titration is strongly recommended to safely obtain the desired level of sedation according to the clinical need, physical status, age and concomitant medication.

In adults over 60 years, debilitated or chronically ill patients and paediatric patients, dose should be determined with caution and risk factors related to each patient should be taken into account. Standard dosages are provided in in Table 1 and additional details are provided in the text following the table.

v. v. v. m. v. m. v. m. m. v. v. v. v. v. v. v. v. The dose must be individualised and titrated and should not be administered by rapid or single bolus injection. g. speed of administration, amount of dose). If necessary, subsequent doses may be administered according to the individual need.

The onset of action is about 2 minutes after the injection. Maximum effect is obtained in about 5 to 10 minutes. v. injection of midazolam should be given slowly at a rate of approximately 1mg in 30 seconds. 5mg given 5 to 10 minutes before the beginning of the procedure.

Further doses of 1mg may be given as necessary. 5mg. A total dose greater than 5mg is usually not necessary. 0 mg and given 5-10 minutes before the beginning of the procedure. 5 to 1mg may be given as necessary. Since in these patients the peak effect may be reached less rapidly, additional midazolam should be titrated very slowly and carefully.

5mg is usually not necessary. V. administration: midazolam should be titrated slowly to the desired clinical effect. The initial dose of midazolam should be administered over 2 to 3 minutes. One must wait an additional 2 to 5 minutes to fully evaluate the sedative effect before initiating a procedure or repeating a dose.

If further sedation is necessary, continue to titrate with small increments until the appropriate level of sedation is achieved. Infants and young children less than 5 years of age may require substantially higher doses (mg/kg) than older children and adolescents.

• Paediatric patients less than 6 months of age: paediatric patients less than 6 months of age are particularly vulnerable to airway obstruction and hypoventilation. For this reason, the use in conscious sedation in children less than 6 months of age is not recommended.

4). ***There have been reports of falls and fractures in benzodiazepine users. The risk of falls and fractures is increased in those taking concomitant sedatives (including alcoholic beverages) and in the elderly. 2).

Dependence:

Use of midazolam - even in therapeutic doses - may lead to the development of physical dependence. v. 4). Cases of abuse have been reported. Severe cardiorespiratory adverse events have occurred. 4). Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

4. m. and rectal administration. 1. Conscious sedation in patients with severe respiratory failure or acute respiratory depression. 4 Special warnings and precautions for use Midazolam should be administered only by experienced physicians in a setting fully equipped for the monitoring and support of respiratory and cardiovascular function and by persons specifically trained in the recognition and management of expected adverse events including respiratory and cardiac resuscitation.

Severe cardiorespiratory adverse events have been reported. These have included respiratory depression, apnoea, respiratory arrest and/or cardiac arrest. 8). Special caution is required for the indication of conscious sedation in patients with impaired respiratory function.

Paediatric patients less than 6 months of age are particularly vulnerable to airway obstruction and hypoventilation, therefore titration with small increments to clinical effect and careful respiratory rate and oxygen saturation monitoring are essential.

When midazolam is used for premedication, adequate observation of the patient after administration is mandatory as interindividual sensitivity varies and symptoms of overdose may occur. Benzodiazepines are not recommended for the primary treatment of psychotic illness.

g. - patients with chronic respiratory insufficiency - patients with chronic renal failure, − patients with impaired hepatic function (benzodiazepines may precipitate or exacerbate encephalopathy in patients with severe hepatic impairment) − patients with impaired cardiac function - paediatric patients especially those with cardiovascular instability.

2) and should be continuously monitored for early signs of alterations of vital functions. As with any substance with CNS depressant and/or muscle-relaxant properties, particular care should be taken when administering midazolam to a patient with myasthenia gravis.

1. Conscious sedation in patients with severe respiratory failure or acute respiratory depression.