Thanks to its good water-solubility and the fact that it induces a pronounced anterograde amnesia, midazolam can be used for various interventions: it is usually administered intramuscularly for pre-operative sedation. It brings about conscious sedation without recall when applied intramuscularly for endoscopies, minor interventions or regional anesthesias. Intravenous midazolam can also be used for the introduction or maintenance of a general anesthesia. Midazolam is further suited for a long-term sedation in the intensive care unit (possibly with continuous infusion). Combined with ketamine, midazolam reduces the cardiovascular side-effects of the former drug.

In comparison with other injectable benzodiazepines (diazepam, flunitrazepam), midazolam has the advantages of shorter duration of efficacy, more potent amnesia, and better venous tolerance.

Midazolam is available in tablet form in Switzerland. According to several studies, it is as efficient as other benzodiazepines when used as a sleeping aid. In view of the pronounced anterograde amnesia its use as a sleeping aid is questionable; oral preparations may, in a given case, be used as pre-operative medication.

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