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Midazolam dosing

Benzos · 1 mg/mL · IV Push

Calculated, not generated

Weight-based dose

DosePer kgFor 70 kg
low0.01 mg/kg0.7 mg
standard0.03 mg/kg2.1 mg
high0.05 mg/kg3.5 mg

Preop: 1-2 mg typical

Renal & hepatic adjustment

  • Severe (eGFR <30 / dialysis)Active metabolite (α-hydroxymidazolam glucuronide) accumulates in renal failure → prolonged sedation; reduce and monitor.
  • Mild–moderate (Child-Pugh A–B)Extensive CYP3A4 metabolism — reduce dose and titrate.
  • Severe (Child-Pugh C)Prolonged sedation in cirrhosis — reduce dose substantially and titrate.

Source: Stoelting's Pharmacology & Physiology

Onset, duration & pearls

Onset1-3 min
Duration1-2 hr

Side effects: Respiratory depression, Paradoxical agitation (elderly), Amnesia.

  • Water-soluble at low pH — less injection pain
  • Strong amnestic properties at low doses

Evidence A · Well-established anxiolytic

More benzos

Get the exact dose for your patient

Vigil computes Midazolam for your patient's actual weight — and adjusts for renal or hepatic impairment automatically, with the cited rationale. The number is calculated from a verified database, never guessed.

Decision support for licensed clinicians — not a substitute for clinical judgment. Always verify against the package insert and the patient in front of you.