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Safety Advices
বাংলা
English
CONSULT YOUR DOCTOR
Midolam is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
SAFE IF PRESCRIBED
Midolam is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
Midolam should be used for short periods and sleepiness of the baby should be watched. The withdrawal of Midolam should be gradual.
Medicine Overview of Midolam 15mg Tablet
Introduction
Midolam is a prescription medicine used as a sedative or for conscious sedation before diagnostic or therapeutic procedures. It relieves anxiety and muscle tensions, thus making the person comfortable before investigations or minor surgical or dental procedures. Midolam reduces anxiety and causes drowsiness. It comes in the form of a nasal spray and taken under the supervision of a healthcare professional only or can be used after the proper guidance of a doctor. Take this medicine in the dose and duration as advised by your doctor as it has a high potential of habit-forming. If you have missed a dose,...
... Show moreUses of Midolam
- Conscious sedation during diagnostic or therapeutic procedures
Side effects of Midolam
Common
- Nasal discomfort
- Throat irritation
How to use Midolam
Use this medicine in the dose and duration as advised by your doctor. Check the label for directions before use. Insert the bottle tip into one nostril and close the other nostril. Direct the spray towards the sides of your nostril, away from the cartilage dividing the two sides of your nose. As you spray, breath gently and keep the head upright. Repeat the same process for the other nostrils.
How Midolam works
Midolam is a benzodiazepine (BZD). It is rapidly absorbed into the bloodstream through the inner lining of the nose. Once absorbed, it works by increasing the action of GABA, a chemical messenger which suppresses the abnormal and excessive activity of the nerve cells in the brain. This helps the patient to recover from a seizure faster.
What if you forget to take Midolam?
If you miss a dose of Midolam, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
- The addiction / habit-forming potential of this medicine is very high. Take it only as per the dose and duration advised by your doctor
- It may cause dizziness. Do not drive or do anything that requires mental focus until you know how this medicine affects you.
- Avoid consuming alcohol as it may increase dizziness and drowsiness.
- Inform your doctor if you are pregnant, planning to conceive or breastfeeding.
- Do not stop taking medication suddenly without talking to your doctor as that may lead to nausea, anxiety, agitation, flu-like symptoms, sweating, tremor, and confusion.
Brief Description
Indication
Short-term treatment of insomnia.
Sedation in premedication before surgical or diagnostic procedures.
Administration
May be taken with or without food.
Midazolam IV should be administered very slowly.
Adult Dose
Adult
Oral
Short-term management of insomnia
Adult: 7.5-15 mg at bedtime.
Elderly: 7.5 mg at bedtime.
Hepatic impairment: Mild to moderate: Dosage reduction needed. Severe: Contraindicated.
Parenteral
Preoperative Sedation
IM
Adult: 0.07-0.1 mg/kg bodyweight i. m. Usual dose is about 5 mg.
Elderly and debilitated patients: 0.025-0.05 mg/kg
IV
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 I. V.
Child Dose
Oral Seizures Child: 3-6 mth Hospital setting: 2.5 mg; >6 mth to <1 yr 2.5 mg; 1-<5 yr 5 mg; 5-<10 yr 7.5 mg; 10-<18 yr 10 mg. Doses are given as single dose. Sedation 500-750 mcg/kg PO once diluted by juice 20-30 minutes prior to procedure; not to exceed 20 mg 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. Parenteral Sedation IM 100-150 mcg/kg IM; up to 500 mcg/kg used; not to exceed 10 mg IV <6 months: Initial, 50 mcg/kg IV over 2-3 minutes;...
... Show moreContraindication
Severe resp failure or acute resp depression, acute narrow-angle glaucoma, myasthenia gravis, sleep apnoea syndrome; severe hepatic impairment (oral). Concomitant use w/ potent CYP3A4 inhibitors.
Mode of Action
Midazolam is a short-acting benzodiazepine. It exerts sedative and hypnotic, muscle relaxant, anxiolytic and anticonvulsant actions. While the probable anxiolytic action might be as a result of the drug's ability to increase glycine inhibitory neurotransmitter level, the hypnotic/anaesthetic action may be due to the occupation of the benzodiazepine and GABA receptors leading to membrane hyperpolarisation and neuronal inhibition, and further interfering with the re-uptake of GABA at the synapses.
Precaution
Patients w/ heart failure, impaired gag reflex, resp disease, history of alcohol or drug abuse. Patient at risk of falls. Hepatic and renal impairment. Childn, elderly and debilitated patient. Pregnancy and lactation. Avoid abrupt withdrawal after prolonged use. Avoid rapid inj in neonates. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor resp and CV status, BP.
Lactation: Distributed in breast milk, use caution
Side Effect
>10%
Decreased respiratory rate (23%),Apnea (15%)
1-10%
Drowsiness (1-5%),Seizure-like activity (1%),Nausea/vomiting (3%),Cough (1%),Pain at injection site (4-5%)
Frequency Not Defined
Headache,Sedation,Hiccoughs,Delirium,Euphoria
Pediatric
Desaturation,Hypotension,Seizurelike activity,Nystagmus,Paradoxical reactions,Hiccoughs,Apnea
Pregnancy Category Note
Midazolam should be avoided during pregnancy unless there is no safer alternative. Since Midazolam passes into breast milk, it should not be administered to breast-feeding mothers.
Interaction
Increased CNS depression with alcohol, opioids, barbiturates, other sedatives and anaesthetics. Increased respiratory depression with opiates, phenobarbital, other benzodiazepines. Plasma concentrations increased by CYP3A4 inhibitors such as cimetidine, erythromycin, clarithromycin, diltiazem, verapamil, ketoconazole and itraconazole, antiretroviral agents, quinupristin with dalfopristin. Midazolam concentration decreased by phenytoin, carbamazepine, phenobarbital, rifampicin. Halothane, thiopental requirements may be reduced during concurrent use.
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