Hypnofast
Generic Name
Midazolam
Manufacturer
Acme Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| hypnofast 5 mg injection | ৳ 50.00 | N/A |
Description
Overview of the medicine
Hypnofast 5 mg injection is a benzodiazepine derivative primarily used for its sedative, anxiolytic, anticonvulsant, and muscle relaxant properties. It is often used for conscious sedation, pre-anesthetic medication, and induction of anesthesia.
Uses & Indications
Dosage
Adults
Individualized based on patient response, age, physical status, and concomitant medications. For conscious sedation, typically 1-2.5 mg IV over 2 minutes, titrated as needed. For induction of anesthesia, 0.1-0.3 mg/kg IV.
Elderly
Reduced dosages are recommended due to increased sensitivity and slower elimination; often 0.5-1.5 mg IV for conscious sedation, titrated carefully.
Renal_impairment
Dosage adjustment may be necessary in severe renal impairment, monitor for prolonged effects.
How to Take
Administer intravenously (slowly over at least 2 minutes for conscious sedation) or intramuscularly. Avoid intra-arterial injection. Should only be administered by trained personnel in settings equipped for respiratory and cardiovascular monitoring and resuscitation.
Mechanism of Action
Midazolam enhances the effect of gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system, by binding to benzodiazepine receptors on the GABA-A receptor complex. This binding increases chloride ion influx, leading to hyperpolarization and decreased neuronal excitability.
Pharmacokinetics
Onset
IV: 1.5-5 minutes; IM: 5-15 minutes.
Excretion
Primarily renal as glucuronide conjugates.
Half life
1.8-6.4 hours (terminal elimination half-life).
Absorption
Rapidly absorbed after intramuscular injection; bioavailability is high. Oral bioavailability is about 40%.
Metabolism
Primarily hepatic via CYP3A4 to active (1-hydroxymidazolam) and inactive metabolites.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Known hypersensitivity to midazolam or other benzodiazepines
- Severe respiratory depression
- Severe hepatic impairment
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole) in some settings.
Drug Interactions
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death.
CNS Depressants (e.g., alcohol, barbiturates, other sedatives)
Potentiate sedative and respiratory depressant effects.
CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, protease inhibitors)
Significantly increase midazolam plasma concentrations, prolonging and enhancing its effects.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Do not freeze.
Overdose
Symptoms include somnolence, confusion, impaired coordination, diminished reflexes, coma, and respiratory depression. Management involves supportive care, maintaining airway, artificial respiration if needed, and monitoring vital signs. Flumazenil (benzodiazepine receptor antagonist) can be used as an antidote, but with caution due to seizure risk.
Pregnancy & Lactation
Pregnancy Category D. Can cause fetal harm. Avoid during pregnancy unless potential benefits outweigh risks. Excreted in breast milk; caution advised during breastfeeding, potential for infant sedation.
Side Effects
Contraindications
- Acute narrow-angle glaucoma
- Known hypersensitivity to midazolam or other benzodiazepines
- Severe respiratory depression
- Severe hepatic impairment
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole) in some settings.
Drug Interactions
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death.
CNS Depressants (e.g., alcohol, barbiturates, other sedatives)
Potentiate sedative and respiratory depressant effects.
CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, protease inhibitors)
Significantly increase midazolam plasma concentrations, prolonging and enhancing its effects.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Do not freeze.
Overdose
Symptoms include somnolence, confusion, impaired coordination, diminished reflexes, coma, and respiratory depression. Management involves supportive care, maintaining airway, artificial respiration if needed, and monitoring vital signs. Flumazenil (benzodiazepine receptor antagonist) can be used as an antidote, but with caution due to seizure risk.
Pregnancy & Lactation
Pregnancy Category D. Can cause fetal harm. Avoid during pregnancy unless potential benefits outweigh risks. Excreted in breast milk; caution advised during breastfeeding, potential for infant sedation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years when stored correctly, refer to product label.
Availability
Hospitals, clinics, pharmacies
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent (for generic Midazolam)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established midazolam's efficacy and safety for its approved indications, focusing on various routes of administration and patient populations. Ongoing research continues to explore its applications.
Lab Monitoring
- Respiratory rate and oxygen saturation
- Blood pressure and heart rate
- Level of consciousness
- Cardiac rhythm (ECG)
Doctor Notes
- Closely monitor respiratory and cardiovascular status.
- Titrate dose slowly to desired effect, especially in elderly or debilitated patients.
- Be prepared for respiratory support and resuscitation.
- Assess for benzodiazepine withdrawal syndrome after prolonged use.
- Avoid rapid intravenous injection.
Patient Guidelines
- Do not operate machinery or drive a vehicle for at least 24 hours after administration.
- Avoid alcohol and other CNS depressants for at least 24 hours.
- Report any unusual or severe side effects immediately.
- Ensure a responsible adult escorts you home after discharge.
Missed Dose Advice
Hypnofast injection is typically given in a controlled clinical setting. If a scheduled dose is missed in an intensive care continuous infusion, the medical team will adjust the regimen as necessary. Do not self-administer or adjust doses.
Driving Precautions
Avoid driving or operating heavy machinery for at least 24 hours after receiving the injection, or longer if residual effects persist, due to potential sedation and impaired coordination.
Lifestyle Advice
- Follow post-procedure instructions carefully.
- Maintain open communication with your healthcare provider regarding any concerns.
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