Dormicum Dosage/Direction for Use

Tablet: Treatment should be as short as possible. Generally, the duration of treatment varies from a few days to a maximum of 2 weeks. The tapering off process should be tailored to the individual.
In certain cases, extension beyond the maximum treatment period may be necessary; if so, it should not take place without re-evaluation of the patient's status. Dormicum should be taken just before going to bed, and swallowed whole with fluid.
Standard Dosage: Adults: Dosage Range: 7.5-15 mg.
Elderly and Debilitated Patients: Recommended Dose: 7.5 mg.
Treatment should be started with the lowest recommended dose. The maximum dose should not be exceeded because of the increased risk of unacceptable CNS adverse effects.
Special Dosage Instructions: Patients with Impaired Liver Function: Recommended Dose: 7.5 mg. Dormicum can be taken at any time of the day, provided the patient is subsequently assured of at least 7-8 hrs undisturbed sleep.
If the patient concomitantly receives cimetidine, erythromycin, diltiazem, verapamil, ketoconazole and itraconazole, see Special Dosing Instructions under Interactions.
Premedication: In premedication, Dormicum tablet should be given 30-60 min before the procedure, unless the parenteral route is preferred.
Ampoule: Midazolam is a potent sedative agent which requires slow administration and individualization of dosage.
The dose should be individualized and titrated to the desired state of sedation according to the clinical need, physical status, age and concomitant medication.
In adults >60 years, debilitated or chronically ill patients, the dose should be determined with caution, the special factors relating to each patient being taken into consideration.
IV Conscious Sedation: The IV injection of Dormicum should be given slowly at a rate of approximately 1 mg in 30 sec. The drug takes effect in about 2 min after the injection has been given.
In adults <60 years, the initial dose is 2.5 mg given 5-10 min before the beginning of the procedure.
Further doses of 1 mg may be given as necessary.
A total dose >5 mg is usually not necessary. In adults >60 years, debilitated or chronically ill patients, the initial dose must be reduced to 1-1.5 mg and given 5-10 min before the beginning of the procedure.
Further doses of 0.5-1 mg may be given as necessary. A total dose >3.5 mg is usually not necessary.
Anesthesia: Premedication: Premedication with Dormicum given shortly before a procedure does produce sedation (induction of sleepiness or drowsiness and relief of apprehension) and preoperative impairment of memory.
Dormicum can also be administered in combination with anticholinergics.
The premedication is usually administered 20-60 min before induction of anesthesia.
IM Administration: In adults <60 years, the dose of Dormicum ranges from 0.07-0.1 mg/kg according to the general condition of the patient.
The usual dose is 5 mg.
In adults >60 years, debilitated or chronically ill, the dose range is from 0.025-0.05 mg/kg.
The usual dose is 2-3 mg.
In children between 1 and 15 years, proportionally higher doses are required than in adults in relation to body weight. The dose range from 0.08-0.2 mg/kg body weight has been shown to be effective and safe.
Dormicum should be administered deep into a large muscle mass 30-60 min prior to the induction of anesthesia.
Induction: The desired level of anesthesia is reached by stepwise titration.
The IV induction dose of Dormicum should be given slowly in increments.
Each increment of not more than 5 mg should be injected over 20-30 sec allowing 2 min between successive increments.
In premedicated adults <60 years, the dose can range from 0.15-0.2 mg/kg but a total dose >15 mg is usually not necessary.
In non-premedicated adults <60 years, the dose may be higher (0.3-0.35 mg/kg body weight), but a total dose >20 mg is usually not necessary.
In adults >60 years, debilitated or chronically ill patients, lower doses will be required.
Maintenance: The maintenance of the desired level of unconsciousness can be achieved by either further intermittent doses or continuous infusion of IV Dormicum typically in combination with analgesics.
The maintenance dose usually ranges from 0.03-0.1 mg/kg/hr when used in combination with narcotics or ketamine.
In adults >60 years, debilitated or chronically ill patients, lower maintenance doses will be required.
In children receiving ketamine for anesthesia (ataralgesia), an IM dose of Dormicum of 0.15-0.2 mg/kg is recommended.
A sufficiently deep level of sleep is generally achieved after 2-3 min.
IV Sedation in the Intensive Care Unit: The desired level of sedation is reached by stepwise titration of Dormicum followed by either continuous infusion or intermittent bolus.
The IV loading dose should be given in increments.
Each increments of 1-2.5 mg should be injected over 20-30 sec allowing 2 min between successive increments.
The IV loading dose can range from 0.03-0.3 mg/kg but a total dose >15 mg is usually not necessary.
In hypovolemic, vasoconstricted or hypothermic patients, the loading dose should be reduced or omitted.
The maintenance dose can range from 0.03-0.2 mg/kg/hr. The level of sedation should be assessed regularly if permitted by the patient's condition.
In hypovolemic, vasoconstricted or hypothermic patients, the maintenance dose should be reduced, at times to as low as 25% of the usual dose.
When Dormicum is given with potent analgesics, the latter should be administered first so that the sedative effects of Dormicum can be safely titrated on top of any sedation caused by the analgesic.
Special Dosage Instructions: Compatibility with Infusion Solutions: Dormicum solution can be diluted with sodium chloride 0.9%, dextrose 5% and 10%, levulose 5%, Ringer's solution and Hartmann's solution in a mixing ratio of 15 mg midazolam per 100-1000 mL infusion solution. These solutions remain physically and chemically stable for 24 hrs at room temperature, or 3 days at 5°C.
Dormicum solution should not be diluted with Macrodex 6% in dextrose or mixed with alkaline injections.