Midazolam

Midazolam
Clinical data
Pronunciation	/mɪˈdæzəlæm/
Trade names	Versed, others
AHFS/Drugs.com	Monograph
MedlinePlus	a609003
License data	US DailyMed: Midazolam;
Pregnancy; category	AU: C;
Addiction; liability	High
Routes of; administration	By mouth, intramuscular, intravenous, buccal, intranasal
Drug class	Benzodiazepine
ATC code	N05CD08 (WHO) ;
Legal status
Legal status	AU: S4 (Prescription only); BR: Class B1 (Psychoactive drugs); CA: Schedule IV; DE: Prescription only (Anlage III for higher doses); NZ: Class C; UK: POM (Prescription only); US: Schedule IV; EU: Rx-only;
Pharmacokinetic data
Bioavailability	By mouth (variable, around 40%); intramuscular 90%+
Protein binding	97%
Metabolism	Liver: CYP3A3, CYP3A4, CYP3A5
Onset of action	Within 5 min (IV), 15 min (IM), 20 min (oral)
Elimination half-life	1.5–2.5 hours
Duration of action	1 to 6 hrs
Excretion	Kidney
Identifiers
	IUPAC name 8-chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a] [1,4]benzodiazepine;
CAS Number	59467-70-8 ;
PubChem CID	4192;
IUPHAR/BPS	3342;
DrugBank	DB00683 ;
ChemSpider	4047 ;
UNII	R60L0SM5BC;
KEGG	D00550 ; as HCl: D00696 ;
ChEBI	CHEBI:6931;
ChEMBL	ChEMBL655 ;
CompTox Dashboard (EPA)	DTXSID5023320 ;
ECHA InfoCard	100.056.140
Chemical and physical data
Formula	C18H13ClFN3
Molar mass	325.77 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES ClC1=CC=C2C(C(C3=CC=CC=C3F)=NCC4=CN=C(C)N42)=C1;
	InChI InChI=1S/C18H13ClFN3/c1-11-21-9-13-10-22-18(14-4-2-3-5-16(14)20)15-8-12(19)6-7-17(15)23(11)13/h2-9H,10H2,1H3 ; Key:DDLIGBOFAVUZHB-UHFFFAOYSA-N ;
	(verify)

Midazolam, sold under the brand name Versed among others, is a benzodiazepine medication used for anesthesia, premedication before surgical anesthesia, and procedural sedation, and to treat severe agitation. It induces sleepiness, decreases anxiety, and causes anterograde amnesia.

The drug does not cause an individual to become unconscious, merely to be sedated. It is also useful for the treatment of prolonged (lasting over five minutes) seizures. Midazolam can be given by mouth, intravenously, by injection into a muscle, by spraying into the nose, or through the cheek. When given intravenously, it typically begins working within five minutes; when injected into a muscle, it can take fifteen minutes to begin working; when taken orally, it can take 10–20 minutes to begin working.

Side effects can include a decrease in efforts to breathe, low blood pressure, and sleepiness. Tolerance to its effects and withdrawal syndrome may occur following long-term use. Paradoxical effects, such as increased activity, can occur especially in children and older people. There is evidence of risk when used during pregnancy but no evidence of harm with a single dose during breastfeeding.

Midazolam was patented in 1974 and came into medical use in 1982. It is on the World Health Organization's List of Essential Medicines. Midazolam is available as a generic medication. In many countries, it is a controlled substance.