Comparative Pharmacology
Head-to-head clinical analysis: KLONOPIN versus MIDAZOLAM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: KLONOPIN versus MIDAZOLAM.
KLONOPIN vs MIDAZOLAM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Benzodiazepine that binds to GABA-A receptors at the benzodiazepine binding site, enhancing the effect of GABA and increasing chloride ion influx, leading to neuronal hyperpolarization and decreased neuronal excitability.
Midazolam is a benzodiazepine that potentiates gamma-aminobutyric acid (GABA) activity by binding to the benzodiazepine site on GABA-A receptors, enhancing GABA's inhibitory effects, leading to increased chloride ion conductance, hyperpolarization, and neuronal inhibition.
0.5 mg orally three times daily; maximum 20 mg/day
IV: 0.5-2 mg initial, titrate by 0.5-1 mg increments every 2-3 min; typical total 2.5-5 mg. IM: 0.07-0.08 mg/kg (usual 5 mg). Oral: 7.5-15 mg as a single premedication dose.
None Documented
None Documented
Clinical Note
moderateMidazolam + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Midazolam is combined with Fluticasone propionate."
Clinical Note
moderateMidazolam + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Midazolam."
Clinical Note
moderateMidazolam + Erythromycin
"The serum concentration of Erythromycin can be increased when it is combined with Midazolam."
Clinical Note
moderateMidazolam + Cyclosporine
30-40 hours in adults; prolonged in elderly (up to 50-80 hours) and hepatic impairment; clinical context: steady-state achieved in 5-10 days
Terminal elimination half-life: 1.5-2.5 hours in healthy adults; prolonged in elderly (5-6 hours), obesity, hepatic cirrhosis (up to 20 hours), and critical illness.
Renal excretion: ~50-70% as glucuronide metabolites, ~30% as unchanged drug (with enterohepatic recirculation); fecal: <2%
Renal: approximately 45-57% as metabolites (primarily 1-hydroxymidazolam glucuronide) and <1% unchanged; fecal: 2-10% via biliary excretion.
Category C
Category D/X
Benzodiazepine
Benzodiazepine
"The metabolism of Cyclosporine can be decreased when combined with Midazolam."