The need-to-know information for Midazolam


Pearls and Fun Nuggets

1. Possibly a truth serum? 😬 In 2018 it was revealed the CIA considered using Midazolam as a “truth serum” on terrorist suspects in project “Medication”.[66] 

2. Midazolam is cheap 💸  The wholesale price of a vial is about US$0.35.[11]

3. It’s often preferred over Diazepam 💉  Midazolam has a shorter onset of action and a shorter duration, making it a go-to medication for seizures in the ED.  It can also be used bucally and nasally.  No IV needed. [13][14]

4. It’s not without risks though☝ In healthy humans, 0.15 mg/kg of midazolam may cause respiratory depression, which is postulated to be a central nervous system (CNS) effect.[39] When midazolam is administered in combination with fentanyl, the incidence of hypoxemia or apnea becomes more likely.[40]

5. Midazolam has been used for executions 😳 The drug has been introduced for use in executions by lethal injection in certain jurisdictions in the United States in combination with other drugs. It was introduced to replace pentobarbital after the latter’s manufacturer disallowed that drug’s use for executions.[76] Midazolam has been used as part of a three-drug cocktail, with vecuronium bromide and potassium chloride in Florida and Oklahoma prisons.[77]

Patient Perspectives

“My first experience with Versed wasn’t a good one. The doc didn’t give me enough and it wore off before the procedure was done. I just about came off the table when I realized what was going on. Last experience – a good one. I whined to the periodontist that the Halcion I took wasn’t enough. He finally decided to add Versed, and I only remember about 5 seconds after he uttered the word “Versed.” The rest of my memory for the day is gone. I’m told it shut me up too. lol.”


“Versed is a perfectly safe med. And it is amazing at relieving anxiety. It will not put you out on its own and even when used with fentanyl will cause conscious sedation. Propofol is the drug that puts you to sleep. These 3 drugs are not interchangeable ….they just work together. I had a colonoscopy done this am. Had some versed and then some fentanyl. All my anxiety vanished and felt no pain….although I was technically awake. Vaguely recall looking at monitor to see the insides of my colon. Totally relaxing. Great feeling…”


“I was given this medication IV before a radiofrequency nerve ablation. I had absolutely no response and had to tolerate the procedure with no assistance. It was extremely painful and nerve-wracking. They gave me the medication and started the procedure without ever checking to see if I was comfortable.”

Brandon Simpson, PA-C
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