Medicine Information

Arlin

Name: Arlin
Brand: Arlin
Rating: 4.5 (117 reviews)

Injection2 mg/mLBenzodiazepines, Anxiolytics, Sedatives & HypnoticsATC: N05CD08

Generic Name

Midazolam Hydrochloride

Manufacturer

Square Pharmaceuticals PLC

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
arlin 2 mg injection	৳ 450.00	N/A

Description

Overview of the medicine

Arlin 2 mg Injection contains Midazolam Hydrochloride, a short-acting benzodiazepine. It is primarily used for procedural sedation, pre-operative anxiolysis, induction of anesthesia, and as a continuous infusion for sedation in critically ill patients.

Uses & Indications

Procedural sedation (e.g., endoscopy, minor surgical procedures)

Pre-operative anxiolysis and sedation

Induction of general anesthesia

Sedation in intensive care units (ICU)

Treatment of status epilepticus (off-label)

Dosage

Adults

Dosage varies widely based on indication, patient age, concomitant medications, and clinical response. For procedural sedation, typically 1-2.5 mg IV slowly. For induction of anesthesia, 0.15-0.35 mg/kg IV.

Elderly

Lower doses are generally required (e.g., 0.5-1 mg IV for procedural sedation) due to increased sensitivity and slower metabolism. Reduce initial dose by at least 25-50%.

Renal_impairment

Initial doses should be reduced, and patients should be monitored for prolonged sedative effects due to accumulation of active metabolites.

How to Take

Administer intravenously slowly over at least 2 minutes for sedation, or intramuscularly deep into a large muscle mass. Continuous infusion requires dilution and an infusion pump. Always administer in a setting with monitoring capabilities for vital signs and respiratory function.

Mechanism of Action

Midazolam enhances the effect of gamma-aminobutyric acid (GABA) by binding to the benzodiazepine site on the GABA-A receptor, leading to increased chloride ion influx, hyperpolarization, and decreased neuronal excitability in the central nervous system.

Pharmacokinetics

Onset

IV: 1-5 minutes; IM: 15-30 minutes.

Excretion

Primarily excreted in urine as glucuronide conjugates of metabolites (60-70%), with a small amount excreted in feces.

Half life

1.5-2.5 hours (terminal half-life).

Absorption

Rapid and complete absorption after intramuscular (IM) administration; intravenous (IV) administration provides immediate and complete bioavailability.

Metabolism

Extensively metabolized in the liver by the cytochrome P450 3A4 (CYP3A4) enzyme system to active metabolites (primarily 1-hydroxymidazolam).

Side Effects

Contraindications

Hypersensitivity to midazolam or other benzodiazepines
Acute narrow-angle glaucoma
Severe respiratory depression or acute respiratory insufficiency (unless mechanically ventilated)
Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole)

Drug Interactions

Opioids and other CNS Depressants

Increased risk of respiratory depression, profound sedation, and hypotension.

CYP3A4 Inducers (e.g., rifampicin, carbamazepine, phenytoin)

Decrease midazolam plasma concentrations, potentially reducing its efficacy.

CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, protease inhibitors)

Significantly increase midazolam plasma concentrations, prolonging and enhancing its effects. Avoid concomitant use or drastically reduce midazolam dose.

Storage

Store at room temperature (below 30°C). Protect from light. Do not freeze.

Overdose

Symptoms of overdose include somnolence, confusion, impaired coordination, diminished reflexes, coma, and respiratory depression. Management involves supportive care for respiratory and cardiovascular function. Flumazenil, a benzodiazepine receptor antagonist, can be used to reverse the effects but should be used with caution, especially in patients with chronic benzodiazepine use or seizures.

Pregnancy & Lactation

Pregnancy Category D: Midazolam can cause fetal harm when administered to a pregnant woman. It is excreted in breast milk; caution should be exercised when administered to a nursing mother. A decision should be made whether to discontinue nursing or to discontinue the drug.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

5 x 2 mg/mL ampoules10 x 2 mg/mL ampoules

Shelf Life

2-3 years from manufacturing date when stored correctly.

Availability

Hospitals, Clinics, Medical Facilities

Approval Status

Approved by DGDA (Bangladesh)

Patent Status

Expired

WHO Essential Medicine

Yes

Clinical Trials

Midazolam has undergone extensive clinical trials supporting its efficacy and safety for various indications, particularly in anesthesia and critical care settings.

Lab Monitoring

Monitor vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation) continuously during and after administration.
Assess level of consciousness and sedation score.

Doctor Notes

Close monitoring of respiratory and cardiovascular function is crucial during and after midazolam administration.
Have resuscitation equipment and flumazenil readily available.
Adjust dose carefully in elderly, debilitated, or renally/hepatically impaired patients.
Beware of paradoxical reactions, especially in pediatric or elderly patients.

Patient Guidelines

This medication is for hospital use only and administered by trained healthcare professionals.
Patients should not attempt to drive or operate machinery for at least 24 hours after administration.
Inform your doctor about all current medications, including herbal supplements and over-the-counter drugs.
Report any unusual side effects or difficulties breathing immediately.

Missed Dose Advice

This medication is typically administered in a controlled medical setting by a healthcare professional, so missed doses are not usually applicable for self-administration.

Driving Precautions

Do not drive, operate machinery, or engage in any hazardous activities for at least 24 hours after receiving Arlin 2 mg Injection, due to potential for drowsiness, dizziness, and impaired judgment.

Lifestyle Advice

Avoid alcohol and other central nervous system depressants (e.g., other sedatives, antihistamines) for at least 24 hours after midazolam administration, as they can enhance its sedative effects.