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Midazolam

Basic Information

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.

Benzodiazepine

Benzodiazepines are generally hypnotic or anxiolytic depressant drugs.

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Habit-forming

These drugs pose a higher risk of causing habit forming behaviour, take particular care with the amount and frequency they are taken.

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Depressant

Depressants are drugs which reduce arousal and stimulation in the user, characterised by a depressing of mental and physical functions.

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Dose

Oral
Low5-10mg
Common10-15mg
Strong15-30mg.
Insufflated
Low3-7mg
Common7-15mg
Strong15-25mg
Rectal
Low3-7mg
Common7-15mg
Intravenous
Low2.5-5mg
Common5-10mg
Strong10-20mg
Intramuscular
Low3-5mg
Common5-12mg
Strong12-25mg

Duration

oral
Onset10-40 minutes
Duration4-8 hours
After-effects1-12 hours
Insufflated
Onset1-5 minutes
Duration4-8 hours
After-effects1-12 hours
Rectal
Onset15-25 minutes
Duration4-8 hours
After-effects1-12 hours
IV
Onset0-1 minutes
Duration4-8 hours
After-effects1-12 hours
IM
Onset10-20 minutes
Duration4-8 hours
After-effects1-12 hours

Avoid

All other CNS depressants.

Effects

Anxiolytic, Sedative, Muscle Relaxant, Amnesia, Dystaxia, Hypnotic.

Bioavailability

Oral [variable - significant first-pass metabolism] | Insufflated 55% | Intramuscular 90%

Bioavailability:

Oral [Highly variable] | Insufflated 55% | Intramuscular 90%

Dose_to_diazepam

Midazolam - 10mg ~=10mg Diazepam.

See TripSit Wiki for more information about drug interactions

Interactions

Dangerous

  • Alcohol
    • Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.
  • GHB/GBL
    • The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
  • Opioids
    • Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely
  • Tramadol
    • Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

Unsafe

  • PCP
    • Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

Caution

  • Ketamine
    • Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
  • MXE
    • Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.
  • DXM
    • Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

Low risk & Increased Effects

Low risk & Decreased Effects

Low risk & No Synergy

References & Notes

Bioavailability