What are the contraindications of midazolam injection?
Nov 25, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
Contraindications for midazolam injection include: hypersensitivity to the drug, severe respiratory insufficiency, myasthenia gravis, acute alcohol intoxication with coma, and use in intrathecal anesthesia. This medication must be used strictly according to medical instructions. Patients should fully inform their doctor of their medical history and previous medication use before administration. Close monitoring of vital signs such as respiration and heart rate is required during treatment.
Contraindications for midazolam injection mainly include: patients allergic to this product, those with severe respiratory insufficiency, patients with myasthenia gravis, individuals with acute alcohol intoxication accompanied by coma, and use in spinal or epidural anesthesia. Detailed analysis is as follows:
1. Allergic to the drug: Some individuals may be allergic to midazolam or excipients in the formulation. Administration can easily trigger allergic reactions such as rash, itching, and laryngeal edema; severe cases may lead to anaphylactic shock. These individuals must absolutely avoid using the drug to prevent life-threatening consequences.
2. Severe respiratory insufficiency: This medication has central respiratory depressant effects. In patients with severe respiratory insufficiency, its use may further exacerbate respiratory depression, leading to worsened dyspnea, decreased oxygen saturation, and even respiratory arrest.
3. Myasthenia gravis: Patients with myasthenia gravis already have impaired neuromuscular transmission. Midazolam enhances neuromuscular blockade, worsening muscle weakness, potentially causing serious complications such as difficulty swallowing and respiratory distress, thereby endangering patient safety.
4. Acute alcohol intoxication with coma: Both alcohol and midazolam exert central nervous system depression. When used together, they produce a synergistic effect that intensifies CNS suppression, deepens coma, abolishes reflexes, and increases the risk of respiratory and circulatory failure.
5. Spinal or epidural anesthesia: Intrathecal or epidural administration of midazolam may cause severe neurotoxicity, resulting in spinal cord injury and irreversible outcomes such as limb numbness and paralysis. Therefore, administration via spinal or epidural routes is strictly prohibited. Clinically, intravenous or intramuscular injection is typically used.
This medication must be used strictly according to medical instructions. Before administration, patients should fully inform their doctor about their medical history and prior medication use. Vital signs such as respiration and heart rate should be closely monitored during treatment to ensure safe use. Dosage and route of administration must not be altered without authorization.
