The oral route of administration is one of the least predictable methods for administering drugs. This is because all drugs first pass through the liver before entering the blood stream and it is impossible to know the exact dose a person receives. Because of this, all dosages are kept within known safe values. It is not possible to simply give someone who does not feel sufficiently sedated more of a drug and exceed the safe levels in the guidelines. However, the normal dosage will be sufficient for the majority of people.
Midazolam, as a Benzodiazepine, depresses the central nervous system. This means that it can cause a decrease in blood pressure and breathing. This can be good, because if your heart isn't racing, you'll feel calmer. However, it should NOT be mixed with other CNS depressants such as alcohol or antihistamines. We will monitor your heart rate, blood pressure and oxygen saturation levels.
People for whom Midazolam works well find it very calming and relaxing. It often makes them sleep during their appointment and makes dentistry a more pleasant experience for them.
You will need to come in one hour prior to your appointment time to take 1-2 tablets or take this before coming to the surgery. It will take 15- 30 minutes before you feel any effect; the effects will then last for 1-4 hours.
• You will need a responsible adult to collect you, take you home and look after you for the remainder of that day.
• You are not permitted to drive or operate any machinery for 12 hours.
• You must avoid alcohol for the remainder of that day .
• You must avoid sleeping tablets for 6 hours.
• Not conduct any responsible business matters for 24 hours.
Oral sedation is not suitable for everyone and it can interact with a number of other medications. Please ensure that you give a complete list of all medications you are taking and a complete medical history to your dentist.
Midazolam can also be used for children over the age of three. It is given as a liquid (mixed with a sweeter drink as it has a very bitter taste) 30 minutes prior to treatment. Midazolam works very well for some children but will only take the top “25%” off their anxiety. An extremely anxious child may require referral for a general anaesthetic.
Oral Midazolam works well for most, approximately 95%, of children. For a very small number of children it may have no effect or make them more hyperactive (Angry Child Syndrome). Please let us know if your child has experienced this with any other sedatives such as Phenergan.
As with adults the main side effects are a depression of breathing and the cardiovascular system.