Name: MIDAZOLAM (VersedR)
Classification: anxiolytic agent; sedative; anticonvulsant
  • used in the initial control of seizures or in the treatment of status epilepticus
  • has no long-term anticonvulsant activity
  • useful in the management of alcohol withdrawal and delirium tremens
  • muscle relaxant - useful in patient with tetanus
  • Loading Dose:
    • <55 y.o. 2 - 2.5 mg IV direct
    • >55 y.o. 1 - 1.5 mg IV direct
    • (reduce the dose by 30% in patients premedicated with narcotics and CNS depressants)
  • Maintenance Infusion:
    • initiate at 1 - 5 mg/hr; titrate to individual response and to target VAMAAS (tolerance may occur)
    • dosage reductions recommended in patients with CHF, septic shock, renal and/or hepatic dysfunction, low serum albumin, pulmonary insufficiency, COPD, or elderly patients
Administration: IV Infusion:
100 mg/50 mL D5W, NS for syringe pump infusion
Adverse Effects:
  • respiratory depression and partial airway obstruction, especially when combined with narcotics
  • hypertension or hypotension
  • headache, drowsiness, dizziness, excessive sedation
  • thrombophlebitis
  • amnesia, lack of recall
Drug Interactions:
  • opioids/inhalation anaesthetics + midazolam = increased or prolonged sedation
Monitoring Therapy:
  • HR
  • ECG
  • arterial blood pressure
  • respiratory rate
  • response to sedation
CCTC Protocol:
  • May be given IV direct by an approved nurse in CCTC.
  • If ordered as a sedative/anxiolytic agent for a patient receiving mechanical ventilation, must be discontinued when mechanical ventilation ceases.
  • May be continued IV direct post-ventilation if specifically ordered following assessment by physician.
  • Continuous infusion must be admininstered by infusion pump.

Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: January 12, 2017

LHSCHealth Professionals

Last Updated January 12, 2017 | © 2007, LHSC, London Ontario Canada