Methylnaltrexone
Severe
Textbook
Increased number of deaths.
Avoid combination due to increased risk of respiratory depression and death.
Source: G&G 14e
Drug reference
remimazolam
Benzodiazepine · Sedative
BenzodiazepineSedative
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
- MethylnaltrexoneSevereTextbookG&G 14e
- NalmefeneSevereTextbookG&G 14e
- NaloxoneSevereTextbookG&G 14e
- NaltrexoneSevereTextbookG&G 14e
Mechanism
Like other benzodiazepines, remimazolam promotes the binding of the major inhibitory neurotransmitter GABA to the GABAA receptor. It has a faster onset and shorter duration of action compared to midazolam.
Indications
Induction and maintenance of sedation during surgical procedures lasting 30 min or lessUsed as a sedative during medical procedures lasting 30 min or lessprocedural sedation
Dosing
- Adult
- 5 mg
- Max dose
- 1 to 5 mg/min for maintenance of sedation, or repeated boluses of 1.25 to 2.5 mg every 2 min
Pharmacokinetics
Onset
peak sedative effects 3 to 5 minutes following a single IV dose
Duration
extremely short context sensitivity; prolonged infusions do not result in prolonged, residual effects
Half-life
0.6–0.9
Metabolism
Very rapidly inactivated
Excretion
organ-independent (via plasma esterase activity)
Contraindications
- procedures lasting more than 30 minutes (manufacturer recommendations)
Side effects
Common
HypoxiaDiastolic hypotensionDiastolic or systolic hypertensionside effect profile mimics other benzodiazepines
Drug interactions
Nalmefene
Severe
Textbook
Increased number of deaths.
Avoid combination due to increased risk of respiratory depression and death.
Source: G&G 14e
Naloxone
Severe
Textbook
Increased number of deaths.
Avoid combination due to increased risk of respiratory depression and death.
Source: G&G 14e
Naltrexone
Severe
Textbook
Increased number of deaths.
Avoid combination due to increased risk of respiratory depression and death.
Source: G&G 14e
Other Cns Depressants
Severe
Textbook
Excessive impairment.
Source: KDT 7e · p406
Alfentanil
Severe
Database
Increased number of deaths.
Avoid combination due to increased risk of respiratory depression and death.
Source: DDInter
Benzhydrocodone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Buprenorphine
Severe
Database
Increased number of deaths.
Avoid combination due to increased risk of respiratory depression and death.
Source: DDInter
Butorphanol
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Clozapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Codeine
Severe
Database
Increased number of deaths.
Avoid combination due to increased risk of respiratory depression and death.
Source: DDInter
Dextropropoxyphene
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Induction of labour
FOGSI · Obstetrics & Gynaecology · 2019
Anticoagulant management for dental procedures
ADA_DENTAL · Dentistry · 2015
Diabetes management during Ramadan
ADA · Endocrinology · 2025
Dialysis — initiation and maintenance
ISN_INDIA · Nephrology · 2023
Infective endocarditis prevention
NICE · Cardiology / Dentistry · 2008
Other Benzodiazepine drugs
Ask House about remimazolam
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team