# Midazolam

Source: https://onco.cc/drugs/midazolam/  
OnCo record `midazolam` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Midazolam is a fast, short-acting sedative. In cancer care it is used to keep people comfortable during procedures such as bronchoscopy, and in palliative care as the first medicine for sedation when suffering cannot be relieved any other way.

## Summary

The US injection label covers sedation, anxiolysis and amnesia before or during diagnostic, therapeutic or endoscopic procedures, naming bronchoscopy and "oncology procedures", and induction of general anaesthesia. In the EAPC 2024 framework for palliative sedation midazolam is step 1, with levomepromazine added at step 2 and propofol under an anaesthetist at step 3, and the doses are halved where there are risk factors. NICE NG31 suggests an opioid, a benzodiazepine or both for breathlessness in the last days of life. NICE CG112 lists oral or intranasal midazolam for children having painful procedures at minimal or moderate sedation. The Versed NDA was approved on 20 December 1985.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-11-11
- Tags: supportive; generic; supportive-care-gaps-2026-11
- Brand: Versed / Hypnovel / Buccolam
- Modality: Benzodiazepine sedative (injection, oral, buccal)
- Mechanism: A short-acting benzodiazepine that enhances GABA-A receptor signalling, giving sedation, anxiety relief and amnesia.
- Approvals: US 1985: Sedation, anxiolysis and amnesia for procedures (including oncology procedures); induction of general anaesthesia; sedation of intubated patients

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Midazolam
- US label (DailyMed): midazolam injection: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=06e4f754-72df-4eb4-aaed-b538524f5277
- Surges et al., Revised EAPC recommended framework on palliative sedation (Palliat Med 2024), table of medications: https://doi.org/10.1177/02692163231220225
- NICE NG31: Care of dying adults in the last days of life, recommendations: https://www.nice.org.uk/guidance/ng31/chapter/Recommendations
- NICE CG112: Sedation in under 19s, using sedation for diagnostic and therapeutic procedures, recommendations: https://www.nice.org.uk/guidance/cg112/chapter/Recommendations

## Connected records

- drugs: [Ketamine](https://onco.cc/drugs/ketamine/), [Levomepromazine](https://onco.cc/drugs/levomepromazine/), [Lidocaine](https://onco.cc/drugs/lidocaine/), [Propofol](https://onco.cc/drugs/propofol/)
- technologies: [Early integrated palliative care](https://onco.cc/technologies/palliative-care/)
- terms: [Palliative sedation](https://onco.cc/terms/palliative-sedation/)

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