Midazolam
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| PsychonautWiki | TripSit | Pharmacology | DrugCentral | DailyMed | ||
|---|---|---|---|---|---|---|
| Classification | ||||||
| Class / category | — | — | — | ≈ | ||
| Also known as | MidazolamVersed | — | — | — | — | |
| Safety | ||||||
| Dose · Intravenous | ||||||
| Threshold | 1 mg | — | — | — | — | |
| Light | 1–2 mg | 2.5–5 mg | — | — | — | ≠ |
| Common | 2–4 mg | 5–10 mg | — | — | — | ≠ |
| Strong | 4–5 mg | 10–20 mg | — | — | — | ≠ |
| Heavy | 5 mg+ | — | — | — | — | |
| Dose · Oral | ||||||
| Threshold | 1 mg | — | — | — | — | |
| Light | 2.5–5 mg | 5–10 mg | — | — | — | ≠ |
| Common | 5–15 mg | 10–15 mg | — | — | — | ≠ |
| Strong | 15–30 mg | 15–30 mg | — | — | — | = |
| Heavy | 30 mg+ | — | — | — | — | |
| Dose · Insufflated | ||||||
| Light | — | 3–7 mg | — | — | — | |
| Common | — | 7–15 mg | — | — | — | |
| Strong | — | 15–25 mg | — | — | — | |
| Dose · Intramuscular | ||||||
| Light | — | 3–5 mg | — | — | — | |
| Common | — | 5–12 mg | — | — | — | |
| Strong | — | 12–25 mg | — | — | — | |
| Dose · Rectal | ||||||
| Light | — | 3–7 mg | — | — | — | |
| Common | — | 7–15 mg | — | — | — | |
| Duration | ||||||
| Onset | 4–6 minutes | — | — | — | — | |
| Total | 2–6 hours | 4–8 hours | — | — | — | ≠ |
| After-effects | — | 1–12 hours | — | — | — | |
| Pharmacology | ||||||
| Receptor activity | — | — | Translocator proteinGABA-A receptor; anion channelCytochrome P450 3A4Solute carrier family 22 member 1 | GABRG2GABRA3GABRA5GABRB3GABRA1TrhrCYP3A4GabrpABCB1Tspo | — | ≠ |
| Half-life | — | — | **Intravenous**: Six single-dose pharmacokinetic studies involving healthy adults yield an elimination half-life of 1.8 to 6.4 hours (mean of approximately 3 hours). **Intramuscular** Following IM administration of 10 mg midazolam, the mean (±SD) elimination half-life of midazolam was 4.2 (±1.87) hours. **Intranasal** Following the administration of NAYZILAM in clinical trials, median midazolam and 1-hydroxy-midazolam elimination half-lives ranged from 2.1 to 6.2 hours and 2.7 to 7.2 hours, respectively, independent of dose. **Oral** The mean elimination half-life of midazolam ranged from 2.2 to 6.8 hours following single oral doses of 0.25, 0.5, and 1.0 mg/kg of midazolam HCl syrup. **Buccal* The initial and terminal elimination half-lives are 27 and 204 minutes, respectively. Midazolam is extensively protein bound (more than 95%). With an intravenous dose of 0.075 mg/kg, the half-life is 68 min, the apparent volume of distribution is 0.23 L/kg, and the clearance is 13 mL/kg/min. The half-life is prolonged in patients with cirrhosis. ...Most elimination half-life ranged from 2.9-4.5 hours in pediatric patients (6 months to less than 16 years of age) receiving IV midazolam 150 ug/kg. In seriously ill neonates, the terminal elimination half-life is substantially prolonged (ie. 6.5-12 hours). Following a single IV dose in health adults, the half-life of midazolam in the initial distribution phase (t 1/2 alpha) averages 6-20 minutes, and the half-life in the terminal elimination phase (t 1/2 beta) averages 1-4 hours (range: 1-12.3 hours). Limited data suggest that the half-life of midazolam may be prolonged in obese patients (presumably secondary to an increased volume of distribution), geriatric individuals, and patients with impaired hepatic function or with congestive heart failure. The half-life of midazolam is also repeatedly prolonged in patients receiving the drug for induction of anesthesia associated with major surgical procedures... | — | — | |
| Protein binding | — | — | In adults and pediatric patients, midazolam is approximately 97% bound to plasma protein, principally albumin. In healthy volunteers, 1-hydroxy midazolam is bound to the extent of 89%. | — | — | |
Dose at a glance
Each database's primary-route ladder on one shared scale — see where ranges line up or shift.
Duration at a glance
Total duration on one shared scale.
PsychonautWiki summary
Fatal overdose may occur when benzodiazepines are combined with other depressants such as opiates, barbiturates, gabapentinoids, thienodiazepines, alcohol or other GABAergic substances.[1] It is strongly discouraged to combine these substances, particularly in common to heavy doses.
TripSit summary
A common hypnotic, sedative and anxiolytic benzodiazepine. High doses may cause amnesia and loss of inhibitions. Unusually, it is water soluble, and commonly used as a premedication for sedation as the solubility makes it better for IV use than other benzodiazepines.
Fact-sheets from PsychonautWiki. Harm-reduction reference only — not medical advice.