Midazolam: A Review of its Pharmacological Properties and Therapeutic Use

J. W. Dundee, N. J. Halliday, K. W. Harper, R. N. Brogden

Research output: Contribution to journalArticle

278 Scopus citations

Abstract

Midazolam is a short-acting water-soluble benzodiazepine (at pH < 4), a member of a new class of imidazobenzodiazepine derivatives. At physiological pH the drug becomes much more lipid soluble. Water solubility minimises pain on injection and venous thrombosis compared with diazepam administered in organic solvent. Midazolam is a hypnotic-sedative drug with anxiolytic and marked amnestic properties. To date it has been used mostly by the intravenous route, for sedation in dentistry and endoscopic procedures and as an adjunct to local anaesthetic techniques. It has proved less reliable than thiopentone, but preferable to diazepam, as an intravenous induction agent and is unlikely to replace the other well established drugs. However, due to the cardiorespiratory stability following its administration, midazolam is useful for anaesthetic induction in poor-risk, elderly and cardiac patients. The short elimination half-life (1.5-3.5 h) and the absence of clinically important long acting metabolites make midazolam suitable for long term infusion as a sedative and amnestic for intensive care, but clinical trials have yet to be completed. Thus, a combination of properties make midazolam a useful addition to the benzo-diazepine group.

Original languageEnglish (US)
Pages (from-to)519-543
Number of pages25
JournalDrugs
Volume28
Issue number6
DOIs
StatePublished - Dec 1984

ASJC Scopus subject areas

  • Pharmacology (medical)

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    Dundee, J. W., Halliday, N. J., Harper, K. W., & Brogden, R. N. (1984). Midazolam: A Review of its Pharmacological Properties and Therapeutic Use. Drugs, 28(6), 519-543. https://doi.org/10.2165/00003495-198428060-00002