Benzodiazepine

Midazolam

Imidazo-benzodiazepine · Versed

Mechanism: GABA-A potentiation via benzodiazepine binding site.

Calculate dose for your patient

Enter weight (kg or lb). Always verify before administration.

Patient weight

Computed weight

70.0 kg · 154.3 lb

Premedication

1.4 mg – 3.5 mg

= 1.40–3.50 mL (1 mg/mL)

Exceeds typical adult max 2 mg — cap and reassess.

Typical adult: 1–2 mg IV. ↓ in elderly.

Weight is saved on this device for the next calculator you open.

Full dose calculator

Onset

1–3 min IV; 15 min PO

Duration

30–60 min

Metabolism

Hepatic CYP3A4 (active metabolite α-hydroxymidazolam).

Dosing

Adult

Premed: 1–2 mg IV. Induction adjunct: 0.05–0.15 mg/kg.

Pediatric

PO premed: 0.5 mg/kg (max 20 mg). IV: 0.05–0.1 mg/kg.

Indications

Premedication
Procedural sedation
Status epilepticus
Induction adjunct

Contraindications

Acute narrow-angle glaucoma
Hypersensitivity

Side Effects

Respiratory depression (synergistic with opioids)
Hypotension
Paradoxical agitation in elderly/children

Clinical Pearls

1Reverse with flumazenil 0.2 mg IV q1 min (max 1 mg) — caution in chronic users.

2Powerful anterograde amnesia even at low doses.

References & Further Reading

1
Textbook
Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.
2
Textbook
Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.
3
Textbook
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, Holt NF. Clinical Anesthesia. 8th ed. Philadelphia: Wolters Kluwer; 2017.
4
Textbook
Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.