What You Should Know About Versed (Midazolam)

Versed (midazolam) is a benzodiazepine, a type of drug that causes relaxation, sleepiness, and partial or complete loss of memory during use. It's commonly used to help you better tolerate a medical procedure.

Anesthetist adjusting intravenous drip during open heart operating
Thierry Dosogne / Stone / Getty Images

Why Versed Is Used

Versed is typically used for:

  • Sedation during procedures that don't require general anesthesia but do require you to remain calm and relaxed, such as a colonoscopy
  • Sedation after surgery
  • To help keep people in intensive care calm while on a ventilator

Versed can be used in combination with pain medications or other types of sedation. While it is commonly combined with Fentanyl, a powerful pain medication, it can also be combined with Propofol and other medications.

Forms of Versed

Versed is available as an injection, an IV infusion, and a syrup taken orally. It's typically given through an IV so it can take effect quickly. The syrup takes longer to be effective and it's harder to predict when it will take effect. 

The syrup is often used for people who have a feeding tube, whether it is permanent or temporarily inserted, and usually for patients who need sedation for an extended period of time rather than just a few minutes or a few hours.

Versed and Fentanyl

Versed is often combined with Fentanyl, a powerful pain reliever, to provide “conscious sedation," also known as “twilight sleep” or "monitored anesthesia care (MAC)." This type of anesthesia doesn't require you to be on a ventilator during the procedure. 

The two drugs, working together, provide pain relief, relaxation, and amnesia. The purpose is to prevent pain and anxiety during the procedure, and if there is any discomfort or stress, the patient is not likely to remember it.

The combination of versed and fentanyl is also used in the ICU setting, typically through an IV. It can be given to medically induce a type of “coma,” keeping the patient unaware of their surroundings.

This can be necessary if someone cannot be calmed, is in danger of injuring themselves, is resisting the ventilator, or has an illness that causes significant pain (such as a burn). 

Side Effects of Versed

Patients may experience certain side effects on the medication. They include:

  • Loss of memory while the drug is being administered and for a while afterward (The drug is often used because of this side effect.)
  • Slow breathing, which requires close monitoring
  • Agitation, hyperactivity, or combativeness in a small number of people
  • Drowsiness, so you shouldn't drive after receiving it
  • New or increased cough

Versed Home Use

Versed is not appropriate for home use. It's used during procedures or inpatient care. Constant monitoring is required with the use of Versed, so it's rarely used in the hospital outside of surgery, procedure rooms, and intensive care.

Versed Warnings

Versed can cause respiratory depression, meaning the urge to breathe is decreased. Due to this side effect, you should be closely monitored in a healthcare facility while on Versed.

Versed can also increase the respiratory depression effects of other medications, including opioids. Due to this respiratory depression effect, patients with respiratory conditions such as COPD may not be good candidates for Versed. 

People on a ventilator, who may or may not have a respiratory disease, may be given Versed to help them tolerate having a breathing tube in place.

Versed can decrease blood pressure and should be used with caution when a patient has low blood pressure, whether it is caused by shock, sepsis or a normal state for the patient.

Versed should be used with caution in anyone who's breastfeeding or pregnant. It's been shown to cross the placental barrier, meaning that the fetus will receive some of the drug.

Versed is excreted more slowly in people with diminished kidney function, so it may have longer-lasting effects. Lower doses and/or longer recovery periods may be necessary.

Versed Dosages

Unlike most drugs, Versed dosages are based upon the drug's effect rather than your weight. The dose should be adjusted based on the result of the initial dose, meaning that you'll be given more or less of the drug based on how effective it is. 

Your ability to tolerate alcohol often provides a hint of your likely tolerance for Versed. If you become intoxicated easily, you may require less medication than someone who can "hold their liquor."

A Word From Verywell

Versed is a very useful drug for sedation during procedures, but it must be used in the appropriate setting with trained staff present and electronic monitoring in use for safety. 

This medication can cause memory loss and decreased breathing, so it is essential that a trained professional is present to monitor the effects you experience. 

Frequently Asked Questions

  • What is Versed (midazolam) used for?

    Versed is a benzodiazepine used as a sedative before medical or dental procedures. It’s approved for sedation and anesthesia induction but is sometimes prescribed off-label to relieve anxiety and agitation. 

  • Does Versed have any side effects?

    Yes, side effects of Versed include drowsiness, loss of memory, and slower breathing. It can also cause a cough. In some instances, Versed can cause agitation, hyperactivity, or combativeness as it wears off. You should not drive after taking Versed.

  • How long does Versed stay in your system?

    Versed is a short-acting medicine that lasts between one and six hours, depending on the individual. The drug stays in your system and can be detected on a drug test for two days.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Midazolam injection.

  2. Prabhudev AM, Chogtu B, Magazine R. Comparison of midazolam with fentanyl-midazolam combination during flexible bronchoscopy: A randomized, double-blind, placebo-controlled study. Indian J Pharmacol. 2017;49(4):304–311. doi:10.4103/ijp.IJP_683_16

  3. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury National Institute of Diabetes and Digestive and Kidney Diseases. Midazolam.

  4. Michelon H, Pons-Peyneau C, Gourdon M, Le Dastumer B, Teillet L, Herr M. Off-label use of midazolam in older inpatients: analysis of prescribing practices in a French hospital (MIDnight study). Fundam Clin Pharmacol. 2020;34(4):515-517. doi:10.1111/fcp.12532

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