Dormicum

Dormicum is a sedative and hypnotic medication.

Release form and composition

Dormicum solution is released for intramuscular injection, in 1 ml of which contains 5 or 15 mg of the active ingredient - midazolam. Auxiliary substances are: water for injection, sodium chloride, sodium hydroxide, hydrochloric acid. In 1 or 3 ml ampoules.

Dormicum tablets are also produced, with a content of 15 mg of midazolam in each.

Indications for use

According to the instructions, Dormicum is indicated for use in the following cases:

• Prolonged sedation in intensive care;
• Introduction to general anesthesia and its maintenance;
• Premedication before surgery or diagnostic procedures;
• Primary and primary general anesthesia in children (intramuscularly in combination with ketamine;
• Short-term treatment of insomnia.

Contraindications

According to the instructions, Dormicum should not be taken in the following cases:

• Hypersensitivity to the active or auxiliary components of the drug;
• Myasthenia gravis;
• Severe sleep disorders caused by psychosis and severe depressions;
• First trimester of pregnancy;
• Lactation period;
• Anesthesia during labor;
• Myotonia;
• Muscular dystrophy;
• Severe COPD;
• Acute pulmonary insufficiency.

Dormicum is prescribed with caution when:

• Hepatic failure;
• Obesity;
• Children age;
• Respiratory failure;
• Acute alcohol intoxication, accompanied by the suppression of vital functions;
• Shock;
• Coma;
• Sleep apnea;
• CHF.

Dosing and Administration

Dormicum dose is selected individually depending on the patient's age, his physical condition and the corresponding clinical need.

Inside Dormicum tablets for sleep disorders take in a dose of 7.5-15 mg. Patients of advanced age or with impaired liver function are prescribed 7.5 mg each. The duration of therapy is not more than 2 weeks.

For sedation take 7.5-15 mg of the drug for 30-60 minutes before the procedure inside or 10-15 mg intramuscularly for 20-30 minutes. Children should be prescribed Dormicum in a dose of 0.15-0.2 mg per kg of body weight orally or 2.5-5 mg intramuscularly 5–10 minutes before surgery. Old patients are recommended half the adult dose.

As an introductory anesthesia, Dormicum is administered intravenously, slowly, fractionally. Each repeated dose is administered for 20-30 minutes with intervals of 2 minutes. For adult patients with premedication, the dose is 0.15-0.2 mg per kg of weight (not more than 15 mg in total), without premedication - 0.3-0.35 mg per kg of weight (not more than 20 mg in total).

As the main anesthesia, Dormikum is administered intravenously, fractionally or continuously in combination with analgesics at a dose of 0.03-0.1 mg per kg of weight per hour. In combination with ketamine, the dose of Dormicum is 0.03-0.3 mg per kg of body weight per hour, for children with ketamine, it is 0.05-0.2 mg per kg of weight.

For prolonged sedation in intensive care, Dormicum is administered intravenously, fractionally, slowly over 20-30 minutes at intervals of 2 minutes. The total dose is 0.03-0.3 mg per kg of body weight.

Side effects

The use of dormicum can cause the following side effects:

• Cardiovascular system: tachycardia, lowering blood pressure, arrhythmia;
• Respiratory system: shortness of breath, laryngospasm, depression of the respiratory center, difficulty breathing, respiratory arrest or cardiac activity;
• Digestive system: nausea, vomiting, hiccups;
• Nervous system: nervousness, agitation, headache, excessive sedative effect, unusual anxiety, hallucinations, disorientation, confusion, muscle tremor, drowsiness, paradoxical reactions, anterograde amnesia, convulsions, involuntary movements;
• Local reactions: thrombophlebitis and pain at the injection site with intramuscular injection;
• Allergies: urticaria, skin rash, anaphylactoid reactions, angioedema;
• Other side effects of Dormicum: With sudden withdrawal after prolonged intravenous use, Dormicum may cause withdrawal symptoms. Possible drug dependence.

In case of overdose, the following symptoms may develop:

• Paradoxical reactions;
• Deep dream;
• Amnesia;
• Myasthenia gravis;

With extremely high doses of the drug are not excluded:

• Areflexia;
• Coma;
• Depression of the respiratory activity and the heart center;
• Apnea.

In case of overdose, the patient must perform mechanical ventilation and measures to support cardiac activity. In case of an overdose with Dormicum tablets, it is advisable to do a gastric lavage immediately after taking the medication. Overdose symptoms are well controlled by flumazenil, a benzodiazepine antagonist.

special instructions

During the period of medication treatment it is forbidden to drink alcohol, especially during the first 6 hours after taking the medicine.

In connection with undesirable side effects of the drug, it is recommended to use caution when managing potentially dangerous mechanisms that require increased concentration of attention.

Dormicum enhances the CNS depressant effect of antipsychotic drugs (neuroleptics), anxiolytics, hypnotics, narcotic analgesics, antidepressants, ethanol, sedatives, antiepileptic, antihistamine drugs.

The combined use of dormicum and erythromycin, cimetidine, antipsychotic drugs, amiodarone reduces the hepatic clearance of midazolam and slows its excretion.

The use of Dormicum is not indicated for the primary treatment of insomnia arising on the background of depression and psychosis.

Analogs

Structural analogues of Dormicum are drugs:

• Midazolam;
• Flormidal;
• Fulced

Terms and conditions of storage

According to the instructions, Dormicum is recommended to be stored in a dark, dry, cool, out of reach of children. The shelf life of the drug is 5 years from the date of issue.