remimazolam besylate at a glance
Medicine class
Short-acting benzodiazepine sedative and hypnotic
Licensed uses
Procedural sedation and general anaesthesia in adults, depending on the formulation
Administration
Given intravenously by clinicians trained in sedation or anaesthesia, with continuous cardiorespiratory monitoring
Afterwards
Do not drive or operate machinery until fully recovered and cleared by the responsible clinician
What is remimazolam besylate used for?
Selected UK products have different adult indications.
Procedural sedation: producing controlled drowsiness during a diagnostic or therapeutic procedure.
General anaesthesia: inducing and maintaining unconsciousness during surgery.
How does remimazolam besylate work?
Remimazolam binds to benzodiazepine sites on GABA-A receptors, strengthening inhibitory signalling in the brain. This produces sedation, hypnosis and impaired formation of new memories. It is rapidly converted mainly in the liver by carboxylesterase-1 into a much less active metabolite.
remimazolam besylate preparations and strengths
Injection
Route: Parenteral
Strengths: 20 mg, 50 mg
How to take remimazolam besylate
Remimazolam is not taken by mouth. A trained healthcare professional prepares and gives it into a vein in an appropriately equipped clinical setting.
Breathing, oxygen levels and circulation are monitored during administration.
Airway, ventilation and resuscitation equipment must be immediately available.
Tell the team about allergies, myasthenia gravis, liver, breathing or heart problems, pregnancy, breastfeeding, alcohol use and all other medicines.
Follow the clinical team's discharge and activity instructions; do not drive until fully recovered and cleared.
remimazolam besylate side effects
Common or expected effects
- Low blood pressure
- Slow heart rate
- Nausea or vomiting
- Headache or dizziness
- Chills or feeling cold
- Agitation or a prolonged sedative effect
Get urgent medical advice
- Respiratory depression, including slow, shallow or difficult breathing or reduced oxygen levels
- Severe hypotension or bradycardia causing collapse or requiring treatment
- Anaphylaxis, which may cause swelling, wheezing, breathing difficulty or circulatory collapse
remimazolam besylate in pregnancy
Human pregnancy information is limited. As a precaution, UK product information advises avoiding remimazolam during pregnancy. Discuss pregnancy or possible pregnancy with the anaesthetic or procedural team when planning care.
remimazolam besylate while breastfeeding
It is unknown whether remimazolam or its main metabolite enters human milk, and a risk to an infant cannot be excluded. UK product information advises avoiding administration while breastfeeding; when use is necessary, breastfeeding should be interrupted for 24 hours after administration has ended.
remimazolam besylate interactions
The most important established interactions are additive sedative and cardiorespiratory effects.
Opioids
Combined use can cause profound sedation and respiratory depression, so close monitoring is required.
Alcohol
Alcohol can markedly strengthen sedation and respiratory effects and should be avoided before administration as directed by the clinical team.
Common questions about remimazolam besylate
Answers are fully visible for fast scanning and source review.
What is remimazolam besylate used for?
Depending on the selected formulation, it is licensed in adults for procedural sedation or for inducing and maintaining general anaesthesia.
How is remimazolam besylate given?
A trained clinician prepares it and gives it intravenously in a monitored clinical setting.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.