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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
This is a compounded suspension containing midazolam hydrochloride, prepared to a prescriber's order for one patient. Compounded preparations are not FDA-approved. Midazolam is a Schedule IV controlled substance.
These listings cover every salt or ester form of each drug in the FDA National Drug Code Directory.
FDA-approved products containing midazolam are listed in injection, syrup and spray forms. No midazolam product of any kind is listed in suspension form.
Liquid bases can be aqueous or nonaqueous, and USP <795> classifies the preparation by its water activity. Aqueous preparations carry shorter default beyond-use dates than nonaqueous ones. The date printed on the label is the one to follow.
Midazolam is a short-acting benzodiazepine sedative, a Schedule IV controlled substance, that compounding pharmacies prepare as oral, buccal and intranasal solutions.
Midazolam is a short-acting benzodiazepine. It binds the benzodiazepine site on the GABA-A receptor and increases how often the receptor's chloride channel opens in response to GABA, which calms nerve activity and produces sedation, reduced anxiety, amnesia and anti-seizure effects; the antagonist flumazenil reverses it. Manufactured products include midazolam injection (for example Hospira), midazolam hydrochloride syrup (Hikma) and Nayzilam nasal spray (UCB). The injection is FDA-approved for preoperative and procedural sedation, induction of general anesthesia and sedation of ventilated patients; the syrup for sedation, anxiolysis and amnesia in children before procedures, in monitored settings only; and Nayzilam for seizure clusters in epilepsy patients 12 and older. Prescribers may order midazolam compounded as an oral, buccal or intranasal solution at a concentration or in a vehicle not manufactured. Compounded midazolam preparations are not FDA-approved and require a prescription.
Midazolam carries boxed warnings. The injection and syrup labels warn that midazolam has caused respiratory depression and arrest, with deaths, so it is used only where breathing and heart function are continuously monitored with resuscitation equipment and trained staff at hand, with slow individualized dosing and no rapid injection in neonates, and that combining benzodiazepines with opioids can cause profound sedation, breathing failure, coma and death. The Nayzilam label carries the benzodiazepine class boxed warning: risks with opioids; abuse, misuse and addiction; and physical dependence with withdrawal reactions that can be life-threatening if the drug is stopped abruptly. Midazolam is metabolized by CYP3A4, so erythromycin, ketoconazole, itraconazole, diltiazem, verapamil, cimetidine, HIV protease inhibitors and grapefruit juice raise its levels sharply, while carbamazepine, phenytoin, rifampin and St. John's wort lower them. Alcohol and other sedatives add to its effects. It should not be used with acute narrow-angle glaucoma or a benzodiazepine allergy. Use late in pregnancy can cause neonatal sedation and withdrawal. Small amounts pass into milk; LactMed-cited data summarized on drugs.com show milk levels become undetectable within about 4 hours, and the syrup label suggests pumping and discarding milk for 4 to 8 hours. Do not drive for 24 hours after a dose. For nausea, vomiting or rash, talk to your prescriber or pharmacist; get emergency help for slow or stopped breathing, extreme sleepiness, or agitation and jerking movements.
Midazolam is an imidazobenzodiazepine, a positive allosteric modulator at the GABA-A benzodiazepine site. It is about 97 percent protein bound and metabolized by hepatic and intestinal CYP3A4 to the active metabolite alpha-hydroxymidazolam, then excreted renally as glucuronides. Elimination half-life is 1.8 to 6.4 hours (mean about 3 hours) after IV dosing in healthy adults and 2.2 to 6.8 hours after oral dosing in children; oral bioavailability is about 36 percent because of first-pass metabolism, and intranasal and buccal routes peak in roughly 10 to 30 minutes. Labeled indications: midazolam injection for preoperative and procedural sedation, anesthesia induction and ICU sedation; midazolam syrup for pediatric preprocedural sedation; Nayzilam for seizure clusters in patients 12 and older. StatPearls describes buccal midazolam in guideline recommendations for status epilepticus and off-label use for severe agitation; prescribers have ordered compounded oral, buccal or intranasal midazolam solutions in these settings. Dosing, route and concentration are per prescriber. Monitoring: continuous pulse oximetry, respiratory rate, blood pressure and heart rate during sedation, with reversal agent and airway equipment available; dependence with prolonged use. Midazolam is a Schedule IV controlled substance. Under federal DEA rules, electronic prescribing of controlled substances is voluntary; CMS applies a prescriber-level e-prescribing threshold for Medicare Part D, and a number of states mandate it.
Shake the bottle well before every dose so the medication is evenly mixed. Measure with the oral syringe or dosing cup provided, using the milliliter markings, and never a kitchen spoon. Take it by mouth as your label directs. Rinse the syringe after use and recap the bottle.
Water-based suspensions are aqueous preparations. Under USP <795>, a preserved suspension usually carries a beyond-use date of up to 35 days at room temperature or refrigerated; an unpreserved one is refrigerated for up to 14 days. Oil-based suspensions are nonaqueous and may carry up to 90 days. Your label states storage and the beyond-use date. Keep out of reach of children and discard after that date.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Take orally
