Midazolam hydrochloride

  • Hypnovel
  • 4H-Imidazo[1,5-a][1,4]benzodiazepine, 8-chloro-6-(2-fluorophenyl)-1-methyl-, monohydrochloride
White to light yellow, crystalline powder.

Registry Numbers and Inventories.
RTECS class
Drug; Human Data
New Zealand

Formula mass
5.5 (pKa)

Hazards and Protection.
Midazolam hydrochloride injection should be stored at 15-30C and protected from light. When stored as recommended, the commercially available injection has an expiration date of 2 yr following the date of manufacture. The injection was physically stable when frozen for 3 day periods and allowed to thaw at room temperature.
All chemicals should be considered hazardous. Avoid direct physical contact. Use appropriate, approved safety equipment. Untrained individuals should not handle this chemical or its container. Handling should occur in a chemical fume hood.
Chemical splash goggles in compliance with OSHA regulations are advised; however, OSHA regulations also permit other type safety glasses. Whre chemical resistant gloves. To prevent repeated or prolonged skin contact, wear impervious clothing and boots.
Use NIOSH/MSHA approved respirator appropriate for exposure of concern.
Small spills/leaks
Evacuate area and ventilate. Wear protective equipment. If required, use an inert absrobent. Sweep up and place in an appropriate container for disposal. Wash contaminated surfaces.
Midazolam hydrochloride is reportedly stable at a pH of 3-3.6.
Strong oxidizing agents.

Fire fighting
Wear a self-contained breathing apparatus in pressure-demand, MSHA/NIOSH (approved or equivalent), and full protective gear. During a fire, irritating and highly toxic gases may be generated by thermal decomposition or combustion. Use agent most appropriate to extinguish fire.

Exposure effects
Reduced body temperature, respiratory depression, abnormally low blood pressure and low heart rate have been reported in overdose. ataxia, lethargy, sleepiness and slurred speech are common. Coma has been reported. Benzodiazepines may induce or worsen dyskinesia. Patients may be agitated (paradoxical effect) or disorientated, and may experience memory loss, confusion, and difficulty concentrating. Benzodiazepines are excreted in breast milk and may produce effects in the nursing infant. <br>Administration of benzodiazepines prior to delivery may produce signs of poisoning in the neonate. A condition called floppy infant syndrome, characterized by hypotonia that may last several days, may may occur following maternal diazepam use.
Nausea and vomiting have been reported.
Respiratory depression is the primary clinical concern in benzodiazepine overdose. Overdose may depress respiratory rate and tidal volume and airway protective reflexes. Severity will depend on amount ingested and absorbed, type of benzodiazepine ingested (lipophilic (e.g. diazepam or flunitrazepam) versus polar (e.g. lorazepam)) and coingestants. Respiratory arrest has occurred following rapid IV administration. Respiratory arrest may also occur in the three hours after an overdose of flunitrazepam by ingestion (alone or with intake of ethanol).
Bullae have been reported.
For pure benzodiazepine ingestions, effects should be minimal, but may include prolonged dialation of the pupils, nystagmus, and divergence paralysis. Constriction of the pupil is also observed.

First aid
Seek medical attention. If individual is drowsy or unconscious, do not give anything by mouth; place individual on the left side with the head down. Contact a physician, medical facility, or poison control center for advice about whether to induce vomiting. If possible, do not leave individual unattended.
If symptoms develop, move individual away from exposure and into fresh air. If symptoms persist, seek medical attention. If breathing is difficult, administer oxygen. Keep person warm and quiet; seek immediate medical attention.
Flush skin with plenty of soap and water for at least 15 minutes while removing contaminated clothing and shoes.
If symptoms develop, immediately move individual away from exposure and into fresh air. Flush eyes gently with water for at least 15 minutes while holding eyelids apart; seek immediate medical attention.