Metabolism/Excretion
Liver, P450 cyp3A4, undergoes hydroxylation, then glucuronidation; primary metabolite, alpha-hydroxy-midazolam, is active and equipotent to midazolam; eliminated in urine ~63-80% as the active metabolite
Plasma Protein Binding %
Children >1 yo: 97, primarily to albumin
Dose For Normal Renal Function
Consult pediatric reference; doses vary upon indication
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 30-50
100%
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 10-29
75%
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 <10
50%
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: 50%
Supplement For Dialysis [Recommendation Level]: Pd
PD: 50%
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: 100%, titrate to effect, [B]