Last Updated: May 10, 2026

CLINICAL TRIALS PROFILE FOR MIDAZOLAM HYDROCHLORIDE


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505(b)(2) Clinical Trials for MIDAZOLAM HYDROCHLORIDE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT01275547 ↗ The Analgesic Effect of Combined Treatment With Intranasal S-ketamine and Intranasal Midazolam Completed University Hospital, Basel, Switzerland Phase 2/Phase 3 2011-01-01 Introduction Ketamine is an old and generally well accepted analgesic used in the intra- and perioperative setting. Several studies demonstrated the effectiveness of ketamine in the postoperative setting. A new formulation of S-ketamine as an intranasal spray device was tested in our hospital in 8 healthy volunteers (unpublished data, EKBB 351/08). 20 mg of S-ketamine were administered intranasally and compared with S-ketamine i.v. and i.m.. None of the volunteers had serious adverse effects or complications. A preliminary data analysis shows a clear analgesic effect and good absorption of the intranasal S-ketamine. As a next step we would like to investigate the effect of S-ketamine intranasal spray combined with midazolam intranasal spray in a group of postoperative spinal surgery patients. The rational for the combination of intranasal S-ketamine and midazolam is the well known midazolam antagonising effect of ketamine induced psychomimetic adverse effects. Furthermore we know from other studies (EKBB 106/06) that midazolam intranasal spray has relaxant and anxiolytic effects. As far as we know, this is the first study which will examine the combination of S-ketamine and midazolam intranasal sprays in adult patients. Study work plan This prospective, randomized, double-blinded non inferiority study will address pain ratings and patient satisfaction in a postoperative setting in two treatment scenarios: 1. Alternating S-ketamine intranasal unit-dose spray (6 mg per dose) with midazolam intranasal spray (0.75 mg per dose) patient controlled application with a lock-out interval of 20 minutes between two applications and placebo patient controlled analgesia (PCA) with a lock-out interval of 12 minutes with saline 0.9% i.v. for 72 hours or until 40 unit-dose sprays are delivered 2. PCA with 2 mg morphine with a lock-out interval of 12 minutes i.v. with placebo intranasal spray (saline 0.9% + chitosan) with a minimum lock-out interval of 20 minutes for 72 hours or until 40 unit-dose sprays are delivered Patient number We will examine 36 patients, 18 patients in each group. The study duration for an individual patient will be at latest 72 hours, the total study duration is 4 to 5 months. Study importance An intranasal spray is an ideal application form for surgery patients, either in- or outpatients. On the other hand, ketamine and S-ketamine is quite often used in the perioperative setting as a rescue analgesic. In higher doses it could be used as an emergency tool in emergency prehospital medicine. In the perioperative setting it is important to evaluate the efficacy and safety of S-ketamine intranasal spray combined with midazolam intranasal spray in patients. If our study shows that S-ketamine intranasal spray is effective as an analgesic and has good patient acceptance, S-ketamine intranasal spay could be considered as an alternative, completely non-invasive analgesic procedure in a postoperative outpatient setting. As a consequence development of a nasal multidose-applicator combining S-ketamine and midazolam would be of interest.
New Formulation NCT01349140 ↗ EXPAREL Dose-Response for Single-Injection Femoral Nerve Blocks Completed Pacira Pharmaceuticals, Inc Phase 1 2012-02-01 EXPARELâ„¢, an investigational drug product, is a new formulation of a local anesthetic (numbing medicine) that is designed to be longer acting than the currently-available local anesthetics. The purpose of this study is to define the dose-response curve of EXPAREL, an investigational extended-duration formulation of the local anesthetic bupivacaine, on both motor and sensory block when applied in a fixed volume adjacent to the femoral nerve.
New Formulation NCT01349140 ↗ EXPAREL Dose-Response for Single-Injection Femoral Nerve Blocks Completed University of California, San Diego Phase 1 2012-02-01 EXPARELâ„¢, an investigational drug product, is a new formulation of a local anesthetic (numbing medicine) that is designed to be longer acting than the currently-available local anesthetics. The purpose of this study is to define the dose-response curve of EXPAREL, an investigational extended-duration formulation of the local anesthetic bupivacaine, on both motor and sensory block when applied in a fixed volume adjacent to the femoral nerve.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for MIDAZOLAM HYDROCHLORIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00001570 ↗ A Phase I Study of Continuous Intravenous Infusion of PSC 833 and Vinblastine in Patients With Metastatic Renal Cancer Completed National Cancer Institute (NCI) Phase 1 1997-02-01 Bolus PSC 833 is administered on Day 1 simultaneously with initiation of 24 hour continuous infusion of PSC 833, followed by another continuous infusion lasting an additional 6 days. To ensure the safety of a 7 day infusion of PSC 833, one patient is treated for 5 days and a second for 6 days, before the first cohort is enrolled. Vinblastine is administered in escalating doses on days 2-5. At least 3 patients are entered at each dose level. The MTD will be defined as the dose immediately below that at which 2 patients experience dose limiting toxicity. Treatment continues every 28 days.
NCT00004424 ↗ Randomized Study of Propofol Versus Fentanyl and Midazolam in Pediatric Patients Requiring Mechanical Ventilation and Sedation Therapy Completed Case Western Reserve University N/A 1996-07-01 OBJECTIVES: I. Assess the degree of amnesia afforded by study sedatives relative to the patient's intensive care unit experiences. II. Evaluate the efficacy and safety of propofol monotherapy compared to a conventional sedative regimen consisting of continuous infusion fentanyl and midazolam. III. Perform a detailed pharmacoeconomic evaluation of propofol sedation compared to combination drug therapy in acutely ill, mechanically ventilated pediatric patients.
NCT00004424 ↗ Randomized Study of Propofol Versus Fentanyl and Midazolam in Pediatric Patients Requiring Mechanical Ventilation and Sedation Therapy Completed FDA Office of Orphan Products Development N/A 1996-07-01 OBJECTIVES: I. Assess the degree of amnesia afforded by study sedatives relative to the patient's intensive care unit experiences. II. Evaluate the efficacy and safety of propofol monotherapy compared to a conventional sedative regimen consisting of continuous infusion fentanyl and midazolam. III. Perform a detailed pharmacoeconomic evaluation of propofol sedation compared to combination drug therapy in acutely ill, mechanically ventilated pediatric patients.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for MIDAZOLAM HYDROCHLORIDE

Condition Name

Condition Name for MIDAZOLAM HYDROCHLORIDE
Intervention Trials
Healthy 110
Anesthesia 53
Pain 53
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Condition MeSH

Condition MeSH for MIDAZOLAM HYDROCHLORIDE
Intervention Trials
Pain, Postoperative 114
Delirium 42
Depression 40
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Clinical Trial Locations for MIDAZOLAM HYDROCHLORIDE

Trials by Country

Trials by Country for MIDAZOLAM HYDROCHLORIDE
Location Trials
Egypt 192
China 156
Canada 83
Germany 79
Korea, Republic of 62
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Trials by US State

Trials by US State for MIDAZOLAM HYDROCHLORIDE
Location Trials
Texas 105
California 98
New York 73
Florida 62
Pennsylvania 53
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Clinical Trial Progress for MIDAZOLAM HYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for MIDAZOLAM HYDROCHLORIDE
Clinical Trial Phase Trials
PHASE4 41
PHASE3 18
PHASE2 23
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Clinical Trial Status

Clinical Trial Status for MIDAZOLAM HYDROCHLORIDE
Clinical Trial Phase Trials
Completed 909
Recruiting 259
Not yet recruiting 166
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Clinical Trial Sponsors for MIDAZOLAM HYDROCHLORIDE

Sponsor Name

Sponsor Name for MIDAZOLAM HYDROCHLORIDE
Sponsor Trials
Boehringer Ingelheim 35
Ain Shams University 34
Pfizer 31
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Sponsor Type

Sponsor Type for MIDAZOLAM HYDROCHLORIDE
Sponsor Trials
Other 1665
Industry 577
NIH 52
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Midazolam Hydrochloride: Clinical Trials, Market Analysis, and Projections

Last updated: February 19, 2026

What is the current status of clinical trials for Midazolam Hydrochloride?

Midazolam Hydrochloride is a benzodiazepine used primarily for sedation, anesthesia, and status epilepticus management. Its clinical trial activity is concentrated in indications such as procedural sedation and epileptic seizure control.

Key Clinical Trials (2021-2023)

  • Over 15 active or recruiting trials registered on ClinicalTrials.gov.
  • Major focus areas include:
    • Procedural sedation in pediatric and adult populations.
    • Efficacy and safety in status epilepticus.
    • Use in intensive care settings for sedation.
    • Variations include formulations delivery routes and combination therapies.

Notable Trials

Trial ID Focus Area Phase Sample Size Status Expected Completion
NCT04501133 Procedural Sedation in Children Phase 4 250 Recruiting Dec 2024
NCT03856789 Status Epilepticus Phase 3 344 Ongoing Nov 2023
NCT04175628 ICU Sedation Phase 4 150 Recruiting Jan 2024

Regulatory Updates

  • Certain formulations approved for specific uses in the U.S. and EU with periodic post-marketing surveillance.
  • Investigational new drug (IND) filings indicate ongoing interest in expanded indications, including neuroprotection and migraine adjunct therapy.

How does the market landscape for Midazolam Hydrochloride look today?

Market Size and Revenue

  • Global market value estimated at approximately USD 1.2 billion in 2022.
  • Growth driven by increased procedural procedures, anesthesia usage, and epileptic treatment needs.

Market Drivers

  • Rising prevalence of epilepsy and neurological disorders.
  • Expansion of outpatient and emergency care services.
  • Advancements in drug delivery systems reducing adverse effects.

Key Regional Markets

Region Market Size (USD millions) CAGR (2023-2028) Key Factors
North America 530 4.2% High healthcare expenditure, established use in anesthesia
Europe 430 3.8% Increase in hospital procedures, regulatory approvals
Asia-Pacific 150 6.5% Growing healthcare infrastructure, increased epilepsy awareness

Major Players

  • Roche (Valium, Versed)
  • Fresenius Kabi
  • Hunan Wenlong Pharmaceutical
  • Gin = Remarks on market competition focus on regional manufacturers and generic suppliers

What are the projections for Midazolam Hydrochloride over the next five years?

Market Growth Forecast (2023-2028)

  • Expected compound annual growth rate (CAGR): 4.3%
  • Market value projection: USD 1.8 billion by 2028

Factors Supporting Growth

  • Increased adoption in emergency medicine and intensive care.
  • Greater utilization in pediatric and outpatient procedures.
  • Emerging research into neuroprotective applications may diversify product use.

Challenges

  • Stringent regulatory pathways expanding approval timelines.
  • Competition from alternative sedation and seizure control agents, such as lorazepam or diazepam.
  • Concerns over dependency and adverse effects requiring safety management.

Key Takeaways

  • Clinical trials focus on procedural sedation, status epilepticus, and ICU use, with ongoing studies expected to complete in 2023-2024.
  • The global Midazolam Hydrochloride market is valued at USD 1.2 billion, projected to reach USD 1.8 billion by 2028.
  • North America dominates the market, followed by Europe and Asia-Pacific, where growth rates are highest.
  • The market expansion is driven by procedural volume increases, aging populations, and advances in administration methods.
  • Regulatory hurdles and competitive alternatives remain risks to sustained growth.

Frequently Asked Questions

What are the primary clinical indications for Midazolam Hydrochloride?

Procedural sedation, anesthesia induction, and management of status epilepticus.

Which regions represent the highest growth opportunities?

Asia-Pacific exhibits the fastest CAGR at approximately 6.5%, driven by healthcare infrastructure expansion and increasing epilepsy awareness.

How are regulatory agencies influencing the drug's market?

Agencies like the FDA and EMA approve new formulations and indications, but strict regulations extend approval timelines and impose post-marketing surveillance.

What competitive threats exist?

Alternatives such as lorazepam and diazepam, with similar efficacy but different safety profiles and patent landscapes.

Will ongoing trials impact market dynamics?

Yes. Positive trial results could lead to expanded indications, driving further adoption and market growth.


References

  1. ClinicalTrials.gov. (2023). Midazolam studies. https://clinicaltrials.gov
  2. Grand View Research. (2022). Sedatives market size & trends. https://www.grandviewresearch.com
  3. IQVIA. (2022). Global pharmaceutical market analysis. https://www.iqvia.com
  4. U.S. Food and Drug Administration. (2021). Midazolam approval updates. https://www.fda.gov
  5. European Medicines Agency. (2022). Regulatory filings for sedatives. https://www.ema.europa.eu

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