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Midazolam vs. Xanax

Medical and Pharmacy Editor:

Are Midazolam and Xanax the Same Thing?

Midazolam Injection or Syrup and Xanax (alprazolam) are 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.

Brand names for midazolam include Versed.

Xanax is used as an anti-anxiety medication prescribed to treat panic attacks and anxiety disorders.

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

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

Side effects of Xanax that are different from midazolam include memory problems, poor balance or coordination, slurred speech, trouble concentrating, irritability, diarrhea, constipation, increased sweating, upset stomach, blurred vision, appetite or weight changes, swelling in your hands or feet, muscle weakness, dry mouth, stuffy nose, or loss of interest in sex.

Both midazolam and Xanax may interact with alcohol, barbiturates, antibiotics, antifungals, H2 blockers, HIV/AIDS medicines, or other medicines that make you sleepy (such as cold or allergy medicines, other sedatives, narcotics, sleeping pills, muscle relaxers, and medicines for seizures, depression, or anxiety).

Midazolam may also interact with theophylline, aminophylline, calcium channel blockers, or rifampin.

Xanax may also interact with birth control pills, cyclosporine, dexamethasone, ergotamine, imatinib, isoniazid, St. John's wort, or heart or blood pressure medications.

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

What Are Possible Side Effects of Midazolam?

Common side effects of Midazolam include:

  • drowsiness,
  • dizziness,
  • weakness,
  • unsteadiness,
  • depression,
  • loss of orientation,
  • headache,
  • sleep disturbances,
  • problems with thinking or memory,
  • slurred speech,
  • dry mouth,
  • sore gums,
  • runny nose,
  • loss of appetite,
  • diarrhea,
  • constipation, and
  • blurred vision.

What Are Possible Side Effects of Xanax?

Common side effects of Xanax include:

  • Drowsiness
  • Tiredness
  • Dizziness
  • Sleep problems (insomnia)
  • Memory problems
  • Poor balance or coordination
  • Slurred speech
  • Trouble concentrating
  • Irritability
  • Diarrhea
  • Constipation
  • Increased sweating
  • Headache
  • Nausea
  • Vomiting
  • Upset stomach
  • Blurred vision
  • Appetite or weight changes
  • Swelling in your hands or feet
  • Muscle weakness
  • Dry mouth
  • Stuffy nose
  • Loss of interest in sex

What Is Midazolam?

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

What Is Xanax?

Xanax (alprazolam) is indicated for the management of anxiety disorders and the short-term relief of symptoms of anxiety in adults. Xanax is also indicated for the treatment of panic disorder in adults with or without a fear of places and situations that might cause panic, helplessness, or embarrassment (agoraphobia).

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 Xanax?

Xanax may interact with cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, medicine for depression or anxiety, antibiotics, antifungal medicines, antidepressants, and barbiturates. Xanax may also interact with birth control pills, cimetidine, cyclosporine, dexamethasone, ergotamine, imatinib, isoniazid, St. John's wort, heart or blood pressure medications, HIV/AIDS medicines, and seizure medications.

Do not take Xanax if you are allergic to alprazolam, other benzodiazepines, or any of the ingredients in Xanax. See the end of this Medication Guide for a complete list of ingredients in Xanax. you are taking antifungal medicines including ketoconazole and itraconazole.

Do not stop using Xanax without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using Xanax suddenly.

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 Xanax Be Taken?

Take Xanax exactly as your healthcare provider tells you to take it. Your healthcare provider will tell you how much Xanax to take and when to take it. If you take too much Xanax, call your healthcare provider or go to the nearest hospital emergency room right away.

Xanax is a benzodiazepine medicine. Taking benzodiazepines with opioid medicines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma and death.

Xanax can make you sleepy or dizzy, and can slow your thinking and motor skills.

Do not drive, operate heavy machinery, or do other dangerous activities until you know how Xanax affects you.

Do not drink alcohol or take other drugs that may make you sleepy or dizzy while taking Xanax without first talking to your healthcare provider. When taken with alcohol or drugs that cause sleepiness or dizziness, Xanax may make your sleepiness or dizziness much worse.

Do not take more Xanax than prescribed.

Reviewed on 3/14/2019

References:
FDA. Midazolam (Versed) Prescribing Information.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/208878Orig1s000lbl.pdf
Pfizer. Xanax Product Information.
https://www.pfizer.com/products/product-detail/xanax

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