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Midazolam vs. Ativan

Are Midazolam and Ativan the Same Thing?

Midazolam Injection and Syrup are Ativan (lorazepam) benzodiazepines used for different purposes.

Midazolam Injection is used as a sedative before surgery or other medical procedures. Midazolam hydrochloride syrup is used in pediatric patients.

Ativan is used for the management of anxiety disorders, insomnia, panic attacks, and alcohol withdrawal.

Brand names for midazolam include Versed.

Side effects of midazolam and Ativan that are similar include nausea, vomiting, dizziness, drowsiness, tiredness, headache, sleep problems (insomnia), or skin rash.

Side effects of midazolam that are different from Ativan include cough, hiccups, breathing difficulties, chest congestion, agitation, slow heart rate, “oversedation,” or injection site reactions (pain, swelling, redness, stiffness, blood clots, and tenderness).

Side effects of Ativan that are different from midazolam include muscle weakness, blurred vision, loss of balance or coordination, forgetfulness or amnesia, difficulty concentrating, constipation, or changes in appetite.

Both midazolam and Ativan may interact with alcohol, barbiturates, or drugs that make you drowsy (narcotics, psychiatric medicines, anti-anxiety drugs, anti-seizure drugs, antihistamines, muscle relaxants, sleeping pills, or sedatives).

Midazolam may also interact with H2 blockers, theophylline, aminophylline, azole antifungals, protease inhibitors, calcium channel blockers, antibiotics, or rifampin.

Ativan may also interact with MAO inhibitors.

Withdrawal symptoms may occur if you suddenly stop taking midazolam or Ativan.

What Are Possible Side Effects of Midazolam?

Common side effects of Midazolam include:

  • headache,
  • nausea,
  • vomiting,
  • cough,
  • drowsiness,
  • hiccups,
  • “oversedation,” or
  • injection site reactions (pain, swelling, redness, stiffness, blood clots, and tenderness).

What Are Possible Side Effects of Ativan?

Common side effects of Ativan include:

  • Drowsiness
  • Dizziness
  • Tiredness
  • Muscle weakness
  • Headache
  • Blurred vision
  • Sleep problems (insomnia)
  • Loss of balance or coordination
  • Forgetfulness or amnesia
  • Difficulty concentrating
  • Nausea
  • Vomiting
  • Constipation
  • Changes in appetite
  • Skin rash

What Is Midazolam?

Midazolam HCl Injection is a benzodiazepine used as a sedative before surgery or other medical procedures.

What Is Ativan?

Ativan (lorazepam) is a benzodiazepine used for the management of anxiety disorders, insomnia, panic attacks, and alcohol withdrawal.

What Drugs Interact With Midazolam?

Midazolam may interact with H2 blockers, fluconazole, theophylline, aminophylline, erythromycin, or drugs that make you drowsy, such as: narcotics, psychiatric medicines, anti-anxiety drugs, anti-seizure drugs, antihistamines, muscle relaxants, sleeping pills, or sedatives. Tell your doctor all medications and supplements you use. During pregnancy, Midazolam should be used only if prescribed. It may harm a fetus. Infants born to mothers who have used this drug during pregnancy may have withdrawal symptoms. This drug passes into breast milk. Consult your doctor before breastfeeding. Withdrawal symptoms may occur if you suddenly stop taking this medication.

What Drugs Interact With Ativan?

Ativan may interact with alcohol, other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety).

Ativan may also interact with MAO inhibitors.

Acute withdrawal symptoms, such as insomnia, nausea, and vomiting may occur if you suddenly stop taking Midazolam. Withdrawal symptoms may occur when you stop using Ativan including tremor, sweating, muscle cramps, stomach pain, vomiting, unusual thoughts or behavior, and seizure (convulsions).

How Should Midazolam Be Taken?

Dosing of Midazolam is individualized. The recommended premedication dose of midazolam for low risk adult patients below the age of 60 years is 0.07 to 0.08 mg/kg IM (approximately 5 mg IM) administered up to 1 hour before surgery.

How Should Ativan Be Taken?

The usual dose of Ativan for treating anxiety is 2-3 mg/day given in two or three divided doses. Insomnia is treated with 2-4 mg given at bedtime.

Reviewed on 3/14/2019

References:
FDA. Midazolam (Versed) Prescribing Information.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/208878Orig1s000lbl.pdf
RxList. Ativan Side Effects Drug Center.
https://www.rxlist.com/ativan-side-effects-drug-center.htm

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