Midazolam is the active ingredient of Dormicum, Micro Midazolam and Midacum.
General Information
Midazolam is a benzodiazepine medication prescribed for the short-term treatment of Insomnia and for pre-operative insomnia.
This benzodiazepine should in most cases not be used for longer than 2 - 4 weeks as tolerance and physical and psychological dependence can occur. Midazolam shares with other benzodiazepines the risk of abuse, misuse, psychological and/or physical dependence.
If prescribed for longer than 4 weeks your prescriber should periodically reassess the need for midazolam.
How does midazolam work?
Midazolam has an effect on gamma-aminobutyric acid (GABA). GABA is the brain's quieting or tranquilising neurotransmitter, possessing and inhibitive effect on the transmission of nerve signals. Midazolam, and other benzodiazepines, enhances the effect of GABA, thus slowing down the transmission of nerve signals.
Fast facts
Drug schedule: Schedule 5
Available as: Midazolam is available as tablets and injection.
What does it do? Midazolam has sedative properties.
Overdose risk: High
Dependence risk: High
Is midazolam available as a generic? Yes
Is midazolam available on prescription only? Yes
User information
Onset of effect: Within 30 minutes
Duration of action: Up to 12 hours
Dietary advice: Midazolam may be taken with or without food.
Stopping this medicine: Midazolam should not be stopped abruptly. Sudden discontinuation may lead to withdrawal symptoms. The dosage of midazolam should be gradually reduced according to the advice of your doctor.
Prolonged use: Short-term therapy is advised, treatment should generally be no longer than 4-6 weeks, including a tapering off process. Tolerance has been noted with long term use. Do not take midazolam for longer periods unless strictly instructed by your doctor.
Special precautions
Never exceed the prescribed dose of midazolam.
Consult your doctor before using this drug if:
- You have a known hypersensitivity to benzodiazepines
- You have acute closed-angle glaucoma
- You have myasthenia gravis
- You have epilepsy.
- You have liver or kidney disease.
- You have a history of alcohol or substance abuse
- You have a chronic lung disease
- You have a mental illness or suffer from depression
- You suffer from sleep apnoea.
Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.
Infants and children: This medication is not intended for use in children.
Elderly: Use with caution as side effects may be emphasised. Dosage may need adjustment.
Driving and hazardous work: This medication should be avoided as it may cause extreme sedation.
Alcohol: Midazolam's effect may intensify the effect of alcohol and vice versa. Do not consume alcohol while taking this medication as side effects may be drastically pronounced.
Possible side effects:
Side effect |
Frequency |
Consult your doctor |
Common |
Rare |
Only if severe |
In all cases |
Extreme Drowsiness |
X |
|
x |
|
Loss of coordination/dizziness |
|
X |
|
x |
Slurred speech |
|
X |
|
x |
Headache |
|
x |
X |
|
Depression |
|
X |
x |
|
Fever/chills |
|
X |
|
x |
Extreme fatigue |
|
X |
|
x |
Libido changes |
|
x |
x |
|
Nausea/vomiting |
|
X |
x |
|
Rash/itching |
|
X |
|
x |
Anger/behaviour changes |
|
X |
|
x |
Impaired memory |
|
X |
|
x |
Interactions:
Drug interactions:
Alcohol, antihistamines, antidepressants, other benzodiazepines, narcotics |
Increased depression of central nervous system (CNS) |
Digoxin |
Increased possibility of digoxin toxicity |
Disulfiram |
Increased possibility of midazolam toxicity |
Ketokonazole and other related Antifungals |
Increased possibility of midazolam toxicity |
Cimetidine |
Increased possibility of midazolam toxicity |
Isoniazid |
Increased possibility of midazolam toxicity |
Oral contraceptive |
Increased possibility of midazolam toxicity |
Propranolol |
Increased possibility of midazolam toxicity |
Valproic acid |
Increased possibility of midazolam toxicity |
Isoniazid |
Increased possibility of a midazolam toxicity |
Levodopa |
Decreases levodopa's anti-Parkinson effect. |
Probenecid |
Increased possibility of midazolam toxicity |
Rifampicin |
May decrease the effect of midazolam. |
Theophylline |
May counteract the sedative effects of midazolam. |
Disease interactions
Consult your doctor before using this drug if you have acute closed-angle glaucoma, myasthenia gravis, liver or kidney disease, a chronic lung disease or epilepsy; also if you have mental illness or suffer from depression or sleep apnoea.
Overdose action
An overdose of midazolam can be serious. Seek immediate emergency medical attention. Symptoms may include poor coordination, slow breathing, tremors, drowsiness, slurred speech, confusion, slow reflexes and loss of consciousness.
Recommended dosage
7.5-15 mg immediately before bedtime