Midazolam

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Nayzilam

Warning

  • This drug may cause very bad and sometimes deadly breathing problems. Call your doctor right away if you have slow, shallow, or trouble breathing.
  • This drug is a benzodiazepine. The use of a benzodiazepine drug along with opioid drugs has led to very bad side effects. Side effects that have happened include slowed or trouble breathing and death. Opioid drugs include drugs like codeine, oxycodone, and morphine. Opioid drugs are used to treat pain and some are used to treat cough. Talk with the doctor.
  • If you are taking this drug with an opioid drug, get medical help right away if you feel very sleepy or dizzy; if you have slow, shallow, or trouble breathing; or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up.
  • Benzodiazepines can put you at risk for addiction, abuse, and misuse. Misuse or abuse of this drug can lead to overdose or death, especially when used along with certain other drugs, alcohol, or street drugs. Addiction can happen even if you take this drug as your doctor has told you. Get medical help right away if you have changes in mood or behavior, suicidal thoughts or actions, seizures, or trouble breathing.
  • Benzodiazepines may cause dependence, especially if taken on a regular basis. This drug is not meant for regular daily use.
  • The risk of dependence and withdrawal are raised the longer you take this drug and the higher the dose. Talk to your doctor before you lower the dose or stop this drug. You will need to follow your doctor’s instructions. Lowering the dose or stopping this drug all of a sudden may cause withdrawal. This can be life-threatening. Get medical help right away if you have trouble controlling body movements, seizures, new or worse behavior or mood changes like depression or thoughts of suicide, thoughts of harming someone, hallucinations (seeing or hearing things that are not there), losing contact with reality, moving around or talking a lot, or any other bad effects.
  • Sometimes, withdrawal signs can last for several weeks to more than 12 months. Tell your doctor if you have anxiety; trouble with memory, learning, or focusing; trouble sleeping; burning, numbness, or tingling; weakness; shaking; muscle twitching; ringing in the ears; or any other bad effects.

What is this drug used for?

  • It is used to calm you before a procedure.
  • It is used to cause sleep during a procedure.
  • It is used to treat seizures.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have glaucoma.
  • If you take any other drugs (prescription or OTC, natural products, vitamins). There are many drugs that interact with this drug, like certain drugs that are used for HIV, infections, or seizures.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks that call for you to be alert until the effects of this drug wear off and you feel fully awake. You may also need to wait for 1 full day after your dose.
  • Use care moving around after getting this drug. You may need help with standing and walking until the effects of this drug have worn off.
  • Talk with your doctor before you use alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
  • Avoid grapefruit and grapefruit juice.
  • If seizures are different or worse after starting this drug, talk with the doctor.
  • Some products are not for use in people 65 or older. The risk of some side effects may be raised. If you have questions, talk with your doctor.
  • If the patient is a child, use this drug with care. The risk of some side effects may be higher in children.
  • This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away.
  • Taking this drug late in pregnancy may raise the chance of breathing or feeding problems, low body temperature, or withdrawal symptoms in the newborn. Talk with the doctor.
  • Tell your doctor if you are breast-feeding or plan to breast-feed. This drug passes into breast milk and may harm your baby.

Liquid (syrup) and injection:

  • Studies in young animals and children have shown that frequent or long-term use of anesthesia drugs or drugs used for sleep in children younger than 3 years of age may lead to long-term brain problems. This may also happen in unborn babies if the mother uses this drug during the third trimester of pregnancy. Talk with the doctor.

Injection:

  • Some products have benzyl alcohol. If possible, avoid products with benzyl alcohol in newborns or infants. Serious side effects can happen in these children with some doses of benzyl alcohol, including if given with other drugs that have benzyl alcohol. Talk with the doctor to see if this product has benzyl alcohol in it.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Chest pain or pressure.
  • Shakiness.
  • Twitching.
  • Very bad dizziness or passing out.
  • Feeling agitated.
  • Trouble controlling body movements.
  • Like other drugs that may be used for seizures, this drug may rarely raise the risk of suicidal thoughts or actions. The risk may be higher in people who have had suicidal thoughts or actions in the past. Call the doctor right away about any new or worse signs like depression; feeling nervous, restless, or grouchy; panic attacks; or other changes in mood or behavior. Call the doctor right away if any suicidal thoughts or actions occur.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

Nose spray:

  • Feeling sleepy.
  • Nose or throat irritation.
  • Runny nose.
  • Headache.
  • Memory problems or loss.

Liquid (syrup) and injection:

  • Feeling sleepy.
  • Feeling tired or weak.
  • Memory problems or loss.

Liquid (syrup):

  • Upset stomach or throwing up.

Injection:

  • Irritation where this drug is given.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

Nose spray:

  • If you will be using this drug at home, your doctor or nurse will teach you how to use it.
  • Do not take this drug by mouth. Use in your nose only. Keep out of your mouth and eyes (may burn).
  • Do not test or prime before using.
  • If the seizure cluster has not stopped 10 minutes after you use this drug, a second dose may be used if your doctor has told you to. Do not use more than 2 doses for the same seizure.
  • If using more than 1 dose, switch nostrils with each dose.
  • If the seizure does not stop after using this drug, get medical help right away.

Liquid (syrup):

  • It is given by mouth only.

Injection:

  • It is given as a shot into a muscle or as an infusion into a vein over a period of time.
  • This drug must not be given into the spine.

What do I do if I miss a dose?

Nose spray:

  • This drug is used on an as needed basis. Do not use more often than told by the doctor.

Liquid (syrup) and injection:

  • Call your doctor to find out what to do.

How do I store and/or throw out this drug?

Nose spray:

  • Store at room temperature.
  • Store this drug in the blister pack that it comes in. Do not open until ready to use. Do not use if the nasal spray is damaged.

Liquid (syrup) and injection:

  • If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.

All products:

  • Store this drug in a safe place where children cannot see or reach it, and where other people cannot get to it. A locked box or area may help keep this drug safe. Keep all drugs away from pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-02-09

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022