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midazolam

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Brand names: Versed

Benzodiazepine Rx

Midazolam is a medicine that makes you feel calm, relaxed, and sleepy. It can also cause you to forget things that happen while you are taking it.

Drug Shortage Alert

midazolam is currently listed as in shortage by the FDA. Affected manufacturer: Gland Pharma Limited. Status: Unavailable.

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Drug Pricing (NADAC)

Generic Price

$0.61/unit

Generic Available

Yes (17 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Midazolam is used to sedate you before a surgery or procedure to help you relax and feel less anxious.

Common side effects

Decreased breathing rate, Tenderness at the injection site, Pain during injection

Key warnings

Midazolam can cause serious breathing problems, including slowed or stopped breathing.

How It Works

Midazolam belongs to a class of drugs called benzodiazepines. It works by slowing down activity in your brain and nervous system. This helps to reduce anxiety, promote relaxation, and cause sleepiness.

How to Take It

Midazolam is given as an injection into a muscle or vein. A healthcare provider will give you this medicine. The dose will be carefully chosen for you. They will watch you closely to make sure the medicine is working safely.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. Midazolam may harm an unborn baby. It is not known if midazolam passes into breast milk. Talk to your doctor about the risks and benefits of using this medicine while breastfeeding.

Missed Dose

Since a healthcare provider gives you this medicine, you are not likely to miss a dose.

Storage

This medicine is stored at room temperature, away from light and moisture.

Side Effects (from patient reports)

Based on 12,982 FDA adverse event reports.

The medicine did not work
2,984
Used for a purpose not approved
2,237
Convulsions
1,373
Low blood pressure
1,296
Medicine affecting another medicine
1,088
Poisoning from different substances
846
Sudden kidney damage
845
Fever
813
Heart stops
811
Death
689

FDA Adverse Event Report Analysis

Detailed analysis of 24,014 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

24,014

Death-Related Reports

4,573

Hospitalization Reports

11,054

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 9,980 (48%)
Male 10,856 (52%)

Age Distribution

0–17 3,562
18–44 5,375
45–64 5,069
65–74 2,766
75+ 2,040

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 2,984
2 OFF LABEL USE 2,237
3 SEIZURE 1,373
4 HYPOTENSION 1,296
5 DRUG INTERACTION 1,088
6 TOXICITY TO VARIOUS AGENTS 846
7 ACUTE KIDNEY INJURY 845
8 PYREXIA 813
9 CARDIAC ARREST 811
10 DEATH 689
11 STATUS EPILEPTICUS 629
12 RESPIRATORY FAILURE 614
13 CONDITION AGGRAVATED 601
14 TACHYCARDIA 583
15 PRODUCT USE IN UNAPPROVED INDICATION 568

Reactions in Death Reports

DEATH 688
DRUG INEFFECTIVE 430
OFF LABEL USE 424
CARDIAC ARREST 392
TOXICITY TO VARIOUS AGENTS 368
HYPOTENSION 293
MULTIPLE ORGAN DYSFUNCTION SYNDROME 288
PNEUMONIA 273
RESPIRATORY FAILURE 273
ACUTE KIDNEY INJURY 243

Reactions in Hospitalization Reports

DRUG INEFFECTIVE 1,635
OFF LABEL USE 1,127
HYPOTENSION 697
PYREXIA 602
DRUG INTERACTION 593
SEIZURE 563
TOXICITY TO VARIOUS AGENTS 485
ACUTE KIDNEY INJURY 458
ANAEMIA 422
CARDIAC ARREST 401

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Midazolam can cause serious breathing problems, including slowed or stopped breathing. This is more likely to happen if you are also taking opioid pain medicines. You must be closely monitored by trained medical staff while receiving midazolam. Make sure the facility has the equipment and medicines needed to treat breathing problems immediately.

Known Drug Interactions

Sedatives/hypnotics: orally administered midazolam, triazolam ↑ midazolam ↑ triazolam Co-administration is contraindicated due to potential for serious and/or life-threatening reactions such as prolonged or increased sedation or respiratory depression. Triazolam and orally administered midazolam are extensively metabolized by CYP3A. Co-administration of triazolam or orally administered midazolam with darunavir may cause large increases in the concentrations of these benzodiazepines.

Mechanism: Darunavir blocks the enzyme that breaks down midazolam, causing the sedative to build up in your body. This can lead to dangerously deep sleep or breathing problems.

What to do: You should not take these two medicines together because the combination can be life-threatening.

Antipsychotics, Anxiolytics and Hypnotics Alprazolam a Midazolam (IV) a Aripiprazole a Quetiapine Buspirone a Cariprazine Ramelteon Diazepam a Risperidone a Haloperidol a Suvorexant Monitor for adverse reactions. Lurasidone Midazolam (oral) a Pimozide Triazolam a Contraindicated during and 2 weeks after itraconazole treatment.

Mechanism: Itraconazole blocks the breakdown of midazolam, making its calming effects much stronger and potentially dangerous.

What to do: Avoid the oral version of this drug with itraconazole, and ensure a doctor monitors you closely if the IV version is used.

Sedative/hypnotics triazolam, oral midazolam ↑ triazolam ↑ midazolam Co-administration contraindicated due to potential for extreme sedation and respiratory depression [see Contraindications (4) ] . midazolam (administered parenterally) ↑ midazolam Co-administration of midazolam (parenteral) should be done in a setting which ensures close clinical monitoring and appropriate medical management in case of respiratory depression and/or prolonged sedation. Dosage reduction for midazolam should be considered, especially if more than a single dose of midazolam is administered.

Mechanism: Nirmatrelvir/ritonavir makes midazolam stay in your body much longer and at higher levels than normal. This can cause you to become dangerously sleepy or have trouble breathing.

What to do: Avoid taking the oral form of this medicine together; if the injected form is used, your doctor must monitor you closely and may lower your dose.

Other Drug Interactions Caution is advised when midazolam is administered concomitantly with drugs that are known to inhibit the P450-3A4 enzyme system such as cimetidine (not ranitidine), erythromycin, diltiazem, verapamil, ketoconazole and itraconazole.

Mechanism: Ketoconazole blocks the specific liver enzyme that your body uses to break down midazolam. This can cause the midazolam to build up in your system and make its effects much stronger.

What to do: Use this combination with caution as it may cause increased sleepiness. Your doctor may need to lower your dose of midazolam.

moderate verapamil

Other Drug Interactions Caution is advised when midazolam is administered concomitantly with drugs that are known to inhibit the P450-3A4 enzyme system such as cimetidine (not ranitidine), erythromycin, diltiazem, verapamil, ketoconazole and itraconazole. The effects of diltiazem (60 mg tid) and verapamil (80 mg tid) on the pharmacokinetics and pharmacodynamics of midazolam were investigated in a three-way crossover study (n=9). The half-life of midazolam increased from 5 to 7 hours when midazolam was taken in conjunction with verapamil or diltiazem.

Mechanism: Verapamil interferes with the liver enzyme responsible for clearing midazolam from your body. This causes the midazolam to stay in your blood for a longer period of time.

What to do: Your doctor should use caution when giving these drugs together. Be aware that the sedative effects of midazolam may last longer than expected.

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Common Questions

Can midazolam be given to children?
Yes, midazolam can be given to children, but the dose must be carefully calculated by a doctor.
Can midazolam be mixed with other medicines?
Yes, midazolam can be mixed with certain other medicines in the same syringe, such as morphine or atropine.
What should I tell my doctor before receiving midazolam?
Tell your doctor about all of your medical conditions and all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Can midazolam cause withdrawal symptoms?
Midazolam can cause withdrawal symptoms if you take it for a long time and then suddenly stop. Talk to your doctor before stopping.
Will I remember the procedure after taking midazolam?
Midazolam can cause amnesia, so you may not remember the procedure.
Can I drive after taking midazolam?
No, you should not drive or operate machinery until the effects of the medicine have worn off completely.
What are the signs of an allergic reaction to midazolam?
Signs of an allergic reaction may include rash, hives, itching, swelling, trouble breathing, or wheezing.
Can midazolam affect my blood pressure?
Yes, midazolam can cause changes in blood pressure.
Is midazolam addictive?
Midazolam can be habit-forming. Take it exactly as prescribed by your doctor.
What should I do if I feel agitated or confused after receiving midazolam?
Tell your doctor or nurse immediately if you feel agitated or confused.
What are the common side effects of midazolam?
The most commonly reported side effects of midazolam include Decreased breathing rate, Tenderness at the injection site, Pain during injection. Based on 12,982 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does midazolam interact with other medications?
Yes, midazolam has 39 known drug interactions. Notable interactions include darunavir, itraconazole, nirmatrelvir/ritonavir. Always inform your doctor about all medications you are taking.
What drug class is midazolam?
midazolam belongs to the Benzodiazepine drug class. It requires a prescription (Rx). Midazolam is used to sedate you before a surgery or procedure to help you relax and feel less anxious.
Is midazolam safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. Midazolam may harm an unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Is midazolam currently in shortage?
Yes, midazolam is currently listed as in shortage by the FDA. Affected manufacturer: Gland Pharma Limited. Status: Unavailable. Visit the FDA Drug Shortages database for the latest updates.

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What the FDA Data Shows for midazolam

The FDA label for midazolam (sold under brand names such as Versed) classifies it as a prescription-only medication in the Benzodiazepine class. Midazolam is used to sedate you before a surgery or procedure to help you relax and feel less anxious. Official labeling lists 3 commonly reported side effects, including Decreased breathing rate, Tenderness at the injection site, Pain during injection.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 12,982 voluntary reports. The database also lists 39 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.61.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: December 5, 2023

All federal data sources used on this page