Midazolam
Midazolam is a short-acting benzodiazepine medication commonly used for sedation, anxiety relief, and amnesia during medical procedures. It works by enhancing the effects of GABA, a calming neurotransmitter in the brain, making it valuable for preoperative sedation, anesthesia induction, and critical care settings.
Midazolam is a benzodiazepine sedative used for procedural sedation, anesthesia, and seizure management.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- N05CD08
- RxNorm
- 6960
- Generic
- Midazolam
- Class
- atc-n05
- Brands
- Nayzilam
- Availability
- rx
- Lactation
- unknown
- Routes
- oral, nasal
- Forms
- injection, prefilled syringe, solution, tablet, spray
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 5mg
- Maximum
- consult physician
- Frequency
- single dose for acute seizure
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 2.5mg
- Maximum
- consult physician
- Frequency
- single dose for acute seizure
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 2.5mg
- Maximum
- consult physician
- Frequency
- single dose for acute seizure
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
9 groupspregnancy
generalavoid if possible
avoid use during pregnancy unless benefits significantly outweigh risks
regular fetal monitoring and assessment of uterine activity
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
first trimesteravoid
avoid use during first trimester due to increased risk of congenital malformations
comprehensive fetal ultrasound at 18-20 weeks
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedinguse lowest effective dose
use with caution; consider pumping and discarding milk for 4-6 hours after dose
monitor infant for excessive drowsiness and feeding difficulties
Use with caution and monitor for adverse effects.
geriatric
elderlyreduce dose by 25-50%
use lowest effective dose; start with lowest dose and titrate slowly
monitor for falls, confusion, and respiratory depression
Use with caution and monitor for adverse effects.
pediatric_age
neonatessignificant dose reduction required
use only in controlled medical settings; avoid prolonged infusion
continuous respiratory and cardiac monitoring
Use with caution and monitor for adverse effects.
pediatric_age
children 1 month to 12 yearsreduce dose based on weight
use with caution; appropriate for sedation prior to procedures
continuous monitoring of vital signs and airway patency
Use with caution and monitor for adverse effects.
renal_impairment
severereduce dose by 25-50%
use with caution; monitor for accumulation
monitor renal function and sedation levels
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate to severereduce dose by 25-50%
use with caution; extended elimination half-life expected
monitor liver function and sedation levels
Use with caution and monitor for adverse effects.
hepatic_impairment
mildno adjustment usually required
standard dosing with monitoring
standard monitoring
Statistics and clinical data
Drug class
Midazolam belongs to the benzodiazepine class of medications
Common uses
Primary therapeutic applications of Midazolam
Brand name (Nayzilam)
Nayzilam is the FDA-approved nasal spray formulation for acute seizure treatment
FDA approval year
FDA approval timeline for Midazolam formulations
Used for procedural sedation before minor surgeries and diagnostic procedures, induction and maintenance of anesthesia, management of status epilepticus, sedation in intensive care units, and treatment of severe insomnia (short-term).
Acts as a positive allosteric modulator at GABA-A receptors, enhancing the inhibitory effects of GABA neurotransmitter. This results in sedation, reduced anxiety, muscle relaxation, anterograde amnesia, and anticonvulsant effects.
Can cause respiratory depression when combined with opioids, alcohol, or other CNS depressants. Risk of dependence with prolonged use. Should only be administered by trained healthcare professionals with resuscitation equipment available. Contraindicated in severe respiratory insufficiency, acute narrow-angle glaucoma, and myasthenia gravis. May impair memory formation for the duration of action.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy