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 dextrose 5% or sodium chloride 0.9% 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:
  • continuous heart rate and rhythm
  • blood pressure
  • respiratory rate
  • level of sedation
Adult Critical Care Protocol:
  • May be administered IV direct or by IV infusion by a nurse in Adult Critical Care
  • May be titrated by a nurse in Adult Critical Care.
  • Continuous infusions must be administered by infusion device and the pump library must be enabled.
  • Order written to provide sedation during mechanical ventilation should be discontinued when patient is not longer receiving mechanical ventilation support.

Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: September 19, 2018