Midazolam

General Toxicity Notes
May cause excessive sedation and encephalopathy in ESRD.
Excreted Unchanged %
Hepatic
Half-Life (Normalesrd) Hours
1.2-12.3/Unchanged
Plasma Protein Binding %
93-96
Volume Of Distribution L/Kg
1.0-6.6
Dose For Normal Renal Function
Individualized
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Not applicable, [D]
Supplement For Dialysis [Recommendation Level]: Pd
PD: Not applicable, [D]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, titrate, [A]
References
Bastien O, Bolon M, Flamens C, Lehot JJ, Boulieu R. [Use of midazolam in postoperative sedation of patients with multiple organ failure treated with hemodiafiltration. Clinical study and pharmacokinetics]. Ann Fr Anesth Reanim. 2002; 21: 692-7. [PMID: 12494801] / Bell DM, Richards G, Dhillon S, Oxley JR, Cromarty J, Sander JW, et al. A comparative pharmacokinetic study of intravenous and intramuscular midazolam in patients with epilepsy. Epilepsy Res. 1991; 10: 183-90. [PMID: 1817958] / Bolon M, Bastien O, Flamens C, Paulus S, Boulieu R. Midazolam disposition in patients undergoing continuous venovenous hemodialysis. J Clin Pharmacol. 2001; 41: 959-62. [PMID: 11549100] / Castleden CM, Allen JG, Altman J, St John-Smith P. A comparison of oral midazolam, nitrazepam and placebo in young and elderly subjects. Eur J Clin Pharmacol. 1987; 32: 253-7. [PMID: 3595698] / Crevat-Pisano P, Dragna S, Granthil C, Coassolo P, Cano JP, Francois G. Plasma concentrations and pharmacokinetics of midazolam during anaesthesia. J Pharm Pharmacol. 1986; 38: 578-82. [PMID: 2876073] / Gaudreault P, Guay J, Thivierge RL, Verdy I. Benzodiazepine poisoning. Clinical and pharmacological considerations and treatment. Drug Saf. 1991; 6: 247-65. [PMID: 1888441] / Greenblatt DJ. Benzodiazepine hypnotics: sorting the pharmacokinetic facts. J Clin Psychiatry. 1991; 52 Suppl: 4-10. [PMID: 1680125] / Greenblatt DJ. Pharmacokinetics and pharmacodynamics. Hosp Pract (Off Ed). 1990; 25 Suppl 2: 9-15; discussion 16-8. [PMID: 2114417] / Swart EL, de Jongh J, Zuideveld KP, Danhof M, Thijs LG, Strack van Schijndel RJ. Population pharmacokinetics of lorazepam and midazolam and their metabolites in intensive care patients on continuous venovenous hemofiltration. Am J Kidney Dis. 2005; 45: 360-71. [PMID: 15685515] / Treiman DM. Pharmacokinetics and clinical use of benzodiazepines in the management of status epilepticus. Epilepsia. 1989; 30 Suppl 2: S4-10. [PMID: 2670537] / Tsubo T, Sakai I, Okawa H, Ishihara H, Matsuki A. Ketamine and midazolam kinetics during continuous hemodiafiltration in patients with multiple organ dysfunction syndrome. Intensive Care Med. 2001; 27: 1087-90. [PMID: 11497143]