Midazolam

Midazolam may cause serious or life-threatening breathing problems such as shallow, slowed, or temporarily stopped breathing. Your child should only receive this medication in a hospital or doctor's office that has the equipment that is needed to monitor his or her heart and lungs and to provide life-saving medical treatment quickly if his or her breathing slows or stops. Your child's doctor or nurse will watch your child closely after he or she receives this medication to make sure that he or she is breathing properly. Tell your child's doctor if your child has a severe infection or if he or she has or has ever had any airway or breathing problems or heart or lung disease. Tell your child's doctor and pharmacist if your child is taking any of the following medications: antidepressants; barbiturates such as secobarbital (Seconal); droperidol (Inapsine); medications for anxiety, mental illness, or seizures; narcotic medications for pain such as fentanyl (Actiq, Duragesic, Sublimaze, others), morphine (Avinza, Kadian, MS Contin, others), and meperidine (Demerol); sedatives; sleeping pills; or tranquilizers.

Midazolam is given to children before medical procedures or before anesthesia for surgery to cause drowsiness, relieve anxiety, and prevent any memory of the event. Midazolam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow relaxation and sleep.

Midazolam comes as a syrup to take by mouth. It is usually given as a single dose by a doctor or nurse before a medical procedure or surgery.

This medication may be prescribed for other uses; ask your child's doctor or pharmacist for more information.

Before your child receives midazolam,

• tell your child's doctor and pharmacist if he or she is allergic to midazolam, any other medications, or cherries.
• some medications should not be taken with midazolam. Other medications may cause dosing changes or extra monitoring when taken with midazolam. Make sure you have discussed any medications you are currently taking or plan to take before starting midazolam with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking midazolam, please get the advice of your doctor or pharmacist.
• the following nonprescription or herbal products may interact with midazolam: cimetidine (Tagamet); St. John's wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking midazolam. Do not start any of these medications while taking midazolam without discussing with your healthcare provider
• tell your child's doctor if your child has glaucoma. Your child's doctor may decide not to give your child midazolam.
• tell your child's doctor if your child has or has ever had kidney or liver disease.
• tell your child's doctor if your child is or may be pregnant, or is breast-feeding.
• you should know that midazolam may make your child very drowsy and may affect his or her memory, thinking, and movements. Do not allow your child to ride a bicycle, drive a car, or do other activities that require him or her to be fully alert for at least 24 hours after receiving midazolam and until the effects of the medication have worn off. Watch your child carefully to be sure that he or she does not fall while walking during this time.
• you should know that alcohol can make the side effects of midazolam worse.

Do not let your child eat grapefruit or drink grapefruit juice while taking this medication.

Midazolam may cause side effects. Tell your child's doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• rash

Some side effects can be serious. If your child experiences any of these symptoms, call his or her doctor immediately:

• agitation
• restlessness
• uncontrollable shaking of a part of the body
• stiffening and jerking of the arms and legs
• aggression
• slow or irregular heartbeat

Midazolam may cause other side effects. Call your child's doctor if your child has any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• drowsiness
• confusion
• problems with balance and movement
• slowed breathing and heartbeat
• loss of consciousness

Keep all appointments with your child's doctor.

Ask your child's pharmacist or doctor if you have any questions about midazolam.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines your child is taking, as well as many products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time your child visits a doctor or if he or she is admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Versed^®