In view of the potential onset of apnoea, midazolam should preferably be administered by an anaesthetist. Patients, who have received parenteral midazolam, should be assessed carefully before being allowed to leave the hospital - in general not earlier than 3 hours after administration – and should be accompanied home by a responsible adult.
Midazolam causes a dose-dependent anterograde amnesia. Prolonged amnesia can present problems in outpatients.
Inhibitors of the enzyme CYP3A4 such as azole antifungals, macrolide antibiotics etc. markedly increase the plasma concentrations of midazolam. Concomitant treatment should be avoided. If this is not possible, the midazolam dose should be reduced.
The patient must not drive, or operate machines, for 12 hours.
Ability to drive or use machines: The patient must not drive or operate machinery for a period of 12 hours after administration of midazolam and even longer in case of prolonged sedation which may be seen after repeated or continuous dosing or with concomitant use of other CNS depressants. Sedation, amnesia, loss of concentration and diminished muscle function may have adverse effects on the ability to drive, or to use machines.