Midazolam¶
Overview¶
| Field | Detail |
|---|---|
| Drug class | Benzodiazepine / Hypnotic agent |
| Stock vial | 1 mg/mL or 5 mg/5 mL (1 mg/mL) |
| Reconstituted conc. | N/A (Ready to use) |
| Storage | Room temp; Protect from light |
Preparation¶
Before you start
Ensure the vial contains 1 mg/mL. Check expiry and integrity. Note that older protocols used a higher concentration, but as of March 2020, use 1 mg/mL for all skin testing.
Equipment needed¶
- 1 × Midazolam 1 mg/mL vial
- Normal saline (NS) — for IDT dilutions
- 1 mL syringes × 3 (for test doses)
- 25 G needles
Step 1 — Prepare the SPT solution (1 mg/mL — neat)¶
- Draw up 0.5–1 mL of the stock (1 mg/mL) into a 1 mL syringe.
- Label: "Midazolam SPT 1 mg/mL".
Step 2 — Prepare IDT dilutions¶
Prepare in this order, using a fresh syringe for each step.
- IDT 0.01 mg/mL (1:100):
- Draw 0.1 mL of stock (1 mg/mL) into a 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.1 mg/mL — 1:10).
- Draw 0.1 mL of this 0.1 mg/mL into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.01 mg/mL — 1:100).
- Label: "Midazolam IDT 0.01 mg/mL".
Skin prick test (SPT)¶
| Reagent | Concentration |
|---|---|
| Test solution | Neat (1 mg/mL) |
| Positive control | Histamine 10 mg/mL |
| Negative control | Normal saline |
Interpretation: Wheal ≥3 mm vs negative control = positive.
Intradermal test (IDT)¶
Dilution series¶
| Step | Dilution | Concentration | Preparation |
|---|---|---|---|
| 1 | 1:100 | 0.01 mg/mL | 0.1 mL of 0.1 mg/mL + 0.9 mL NS |
Protocol Note
Midazolam IDT at 1:10 (0.1 mg/mL) should only be performed if the history is highly suspicious and earlier steps are negative, due to the risk of irritant responses.
Inject: 0.05 mL intradermal. Read at 15–20 minutes.