Buy Midazolam (Versed) Cas 59467-70-8

Midazolam, sold under the brand name Versed among others, is a benzodiazepine medication used for anesthesia, premedication before surgical anesthesia, and procedural sedation, and to treat severe agitation.^[12] It induces sleepiness, decreases anxiety, and causes anterograde amnesia.^[12]

The drug does not cause an individual to become unconscious, merely to be sedated.^[12] It is also useful for the treatment of prolonged (lasting over five minutes) seizures.^[14] Midazolam can be given by mouth, intravenously, by injection into a muscle, by spraying into the nose, or through the cheek.^[12][14] When given intravenously, it typically begins working within five minutes; when injected into a muscle, it can take fifteen minutes to begin working;^[12] when taken orally, it can take 10–20 minutes to begin working.^[15]

Side effects can include a decrease in efforts to breathe, low blood pressure, and sleepiness.^[12] Tolerance to its effects and withdrawal syndrome may occur following long-term use.^[16] Paradoxical effects, such as increased activity, can occur especially in children and older people.^[16] There is evidence of risk when used during pregnancy but no evidence of harm with a single dose during breastfeeding.^[17][18]

Midazolam was patented in 1974 and came into medical use in 1982.^[19] It is on the World Health Organization’s List of Essential Medicines.^[20] Midazolam is available as a generic medication.^[17] In many countries, it is a controlled substance.^[12]

Midazolam is sometimes used for the acute management of prolonged seizures. Long-term use for the management of epilepsy is not recommended due to the significant risk of tolerance (which renders midazolam and other benzodiazepines ineffective) and the significant side effect of sedation.^[21] A benefit of midazolam is that in children it can be given in the cheek or in the nose for acute seizures, including status epilepticus.^[22][23]

Drawbacks include a high degree of breakthrough seizures—due to the short half-life of midazolam—in over 50% of people treated, as well as treatment failure in 14–18% of people with refractory status epilepticus. Tolerance develops rapidly to the anticonvulsant effect, and the dose may need to be increased by several times to maintain anticonvulsant therapeutic effects. With prolonged use, tolerance and tachyphylaxis can occur and the elimination half-life may increase, up to days.^[16][24] Buccal and intranasal midazolam may be both easier to administer and more effective than rectally administered diazepam in the emergency control of seizures.^[25][26][27]

Intravenous midazolam is indicated for procedural sedation (often in combination with an opioid, such as fentanyl), preoperative sedation, for the induction of general anesthesia, and for sedation of people who are ventilated in critical care units.^[28][29] Midazolam is superior to diazepam in impairing memory of endoscopy procedures, but propofol has a quicker recovery time and a better memory-impairing effect.^[30] It is the most popular benzodiazepine in the intensive care unit (ICU) because of its short elimination half-life, combined with its water solubility and its suitability for continuous infusion. However, for long-term sedation, lorazepam is preferred due to its long duration of action,^[31] and propofol has advantages over midazolam when used in the ICU for sedation, such as shorter weaning time and earlier tracheal extubation.^[32]