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This factsheet answers some common questions about your child's medicine. It does not contain all available information. It does not take the place of talking to your child's doctor or pharmacist. This information may be different from the information in the manufacturer's consumer information. The information in this factsheet reflects the usage of medicine under medical supervision by patients of The Royal Children's Hospital (RCH). Medicine may be used in children in different ways or for different reasons than in adults - for more information see the Kids Health Info factsheet: Medicines for Children - about.
Midazolam is a benzodiazepine medication like diazepam and clonazepam. Midazolam works more quickly than diazepam but does not last as long.
What is midazolam used for?
Midazolam is used for:
Midazolam can be:
Ambulance officers and emergency doctors give midazolam by injection into a muscle or vein. Intranasal midazolam is absobed directly into the blood stream through the lining of the nose. Swallowing midazolam is not recommended as it is not absorbed well through the stomach. The plastic ampoules are labelled "for slow IV or IM injection" but can be used for buccal and intranasal use.
Midazolam can be used for the emergency treatment of seizures. Midazolam may be prescribed for a child with epilepsy who:
Midazolam is not necessary for all children with epilepsy. Your doctor will tell you whether your child might benefit from you being able to give them midazolam. Intranasal midazolam may be better than buccal midazolam in children who vomit or salivate prominently during seizures.
First aid for seizures is very important. It includes:
Use only 1ml plastic ampoules containing 5mg of midazolam. Do not use midazolam in glass ampoules.
Step 1: Open the plastic ampoule of midazolam by twisting off the top.
Step 2: Insert the syringe into the ampoule and hold the ampoule and syringe upright with the ampoule higher. Withdraw the required dose as prescribed by your doctor into a 1ml syringe. Push out any big air bubbles and check the amount of midazolam in the syringe. Pull the ampoule and the syringe apart.
Step 3: Attach the syringe to the mucosal atomizer device.
Step 4: Lay your child on their side in the first aid (coma) position or in the best position to allow easy administration of intranasal midazolam. Insert mucosal atomizer device loosely into nostril and press the plunger quickly to give half of the prescribed dose. Remove the device and insert into the other nostril to give the remaining dose. Your doctor will have allowed for the 0.1ml residual left in the atomizer
Step 5: Watch your child's breathing and seizure activity while they remain lying on their side in the first aid (coma) position.
Step 6: Write down the time when the seizure started, when the midazolam was given and when the seizure stopped.
Contact your child's paediatrican or neurologist.
Produced in consultation with the RCH Children's Neuroscience Centre & RCH Pharmacy. First published Jan 2006. Updated May 2014.
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