Midazolam – Uses, Dosage, Side Effects | Emergency Antiepileptic

Midazolam

Benzodiazepine for Sedation and Seizure Control

Indication

Used for status epilepticus, procedural sedation, premedication for anesthesia.

Available Form

Injection 1 mg/ml, 5 mg/ml, 15 mg/3 ml; oral syrup 2 mg/ml; intranasal spray.

Dosage

Pediatric (IV/IM): 0.1–0.3 mg/kg, max 10 mg/dose; may repeat every 2–4 hours as needed.

Adult (IV/IM): 1–2.5 mg IV slowly, may repeat every 2–3 min up to 5 mg; max 0.1–0.2 mg/kg.

Intranasal/Percutaneous (Peds): 0.2–0.3 mg/kg, max 10 mg.

⚡ Major Side Effects

Respiratory depression/apnea
Hypotension
Excessive sedation, drowsiness
Paradoxical agitation in some patients

🚫 Contraindications

Severe respiratory insufficiency
Sleep apnea syndrome
Acute narrow-angle glaucoma
Hypersensitivity to benzodiazepines

💧 Compatible Solvent

Dilute with 0.9% NaCl or 5% dextrose for IV infusion. Administer slowly to avoid respiratory depression.

⚠️ Special Precautions

Monitor respiration, oxygen saturation, and blood pressure.
Use caution in elderly and debilitated patients.
Avoid rapid IV injection → risk of apnea.
Do not combine with other CNS depressants unless supervised.