Included in the formulation
Fused
solution
w / m in / in
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
АТХ:N.05.C.D.08 Midazolam
Pharmacodynamics:Water-soluble benzodiazepine of short duration of action. Blocking the reverse capture of the gamma-aminoacetic acid neurotransmitter, which leads to its accumulation.
Has miorelaksiruyuschee, anxiolytic, anticonvulsant, hypnotic and anterograde amnestic effect. Shortens the phase of falling asleep and increases the overall duration and quality of sleep, without changing the phase of paradoxical sleep. Quickly causes the onset of sleep (after 20 minutes), almost does not have the effect of aftereffect.
Pharmacokinetics:After oral intake absorbed in the gastrointestinal tract to 100%, after intramuscular injection, the maximum concentration in the blood plasma is reached after 15-60 minutes. The connection with plasma proteins is 97%.
Penetrates through the blood-brain and placental barrier, is found in breast milk. Metabolism in the liver to 1-hydroxymethylmidazolam and 4-hydroxymidazolam.
Half-life is 2.5 hours. Elimination by the kidneys.
Indications:It is used to treat sleep disorders, with the purpose of premedication before surgery, for the introduction into anesthesia and its maintenance.
V.F50-F59.F51.0 Insomnia inorganic etiology
VI.G40-G47.G47.0 Disturbances of falling asleep and maintaining sleep [insomnia]
XVIII.R40-R46.R45.1 Anxiety and Excitement
XXI.Z100.Z100 * CLASS XXII Surgical Practice
Contraindications:Myasthenia gravis, sleep apnea, sleep disorders in psychoses and severe depression, individual intolerance, children under 3 years old.
Carefully:Organic brain damage, hypersensitivity.
Pregnancy and lactation:The action category for the fetus is FDA-D. Contraindicated in the first trimester of pregnancy and during childbirth. In the second and third trimester, application is possible if the expected effect of therapy exceeds the potential risk to the fetus. For the duration of treatment, breastfeeding should be discontinued.
Dosing and Administration:Inside with sleep disorders of 7.5-15 mg once, just before bedtime. The maximum course of treatment lasts no more than 2 weeks.
Intramuscularly and intravenously - the dosing regimen is selected individually. The maximum dose for parenteral administration is 0.6 mg / kg body weight.
Rectally with the purpose of premedication to children, the dose is calculated individually.
Side effects:Central and peripheral nervous system: lethargy, drowsiness, dizziness, headache, anterograde amnesia, ataxia, hallucinations, delirium after coming out of anesthesia, paradoxical reactions: agitation, aggressiveness, psychomotor agitation.
Respiratory system: bronchospasm, apnea with intravenous injection.
Digestive system: hiccough, nausea, vomiting.
Dermatological reactions: a rash.
Sense organs: diplopia.
Allergic reactions, phlebitis at the injection site.
Overdose:Drowsiness, impaired coordination, confusion, oppression of reflexes, coma.
Antidote - flumazenil, is used in a hospital. Treatment is symptomatic. Hemodialysis is ineffective.
Interaction:Reduces the systemic effect of midazolam when administered inducers of the isoenzyme CYP3A4: carbamazepine, rifampicin, phenytoin.
Increase the half-life of midazolam: itraconazole, saquinavir, erythromycin, fluconazole.
Strengthens the effects of neuroleptics, tranquilizers, sleeping pills, anticonvulsants, analgesics and anesthetics.
With the simultaneous use of blockers of β-adrenoreceptors, calcium channel blockers, diuretics, ACE inhibitors, levodopa, magnesium sulfate and nitrates, the hypotensive effect is enhanced.
Incompatible with alcohol.
Special instructions:In the treatment it is not recommended to drive vehicles and work with moving mechanisms.