Last Updated: May 14, 2026

CLINICAL TRIALS PROFILE FOR MIDAZOLAM IN 0.8% SODIUM CHLORIDE


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505(b)(2) Clinical Trials for MIDAZOLAM IN 0.8% SODIUM CHLORIDE

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 A new formulation of S-ketamine as an intranasal spray device was tested in our hospital in 8 healthy volunteers (unpublished data, EKBB 351/08). 20 mg of S-ketamine were administered intranasally and compared with S-ketamine i.v. and i.m..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 EXPAREL™, 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 EXPAREL™, 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.
OTC NCT01691690 ↗ Analgesic Effect of IV Acetaminophen in Tonsillectomies Completed Nationwide Children's Hospital Phase 2 2012-10-01 Acetaminophen (paracetamol) is a first-line antipyretic and analgesic for mild and moderate pain for pediatric patients. Its common use (particularly in oral form) is underscored by its wide therapeutic window, safety profile, over the counter accessibility, lack of adverse systemic effects (as compared with NSAIDS and opioids) when given in appropriate doses. Although the exact anti-nociceptive mechanisms of acetaminophen continue to be elucidated, these mechanisms appear to be multi-factorial and include central inhibition of the cyclo-oxygenase (COX) enzyme leading to decreased production of prostaglandins from arachidonic acid, interference with serotonergic descending pain pathways, indirect activation of cannabinoid 1 (CB1) receptors and inhibition of nitric oxide pathways through N-methyl-D-aspartate (NMDA) or substance P. Of the above mechanisms, the most commonly known is that of central inhibition of COX enzymes by which the decreased production of prostaglandins diminish the release of excitatory transmitters of substance P and glutamate which are both involved in nociceptive transmission (Anderson, 2008; Smith, 2011). To date, several studies have shown acetaminophen's opioid sparing effect in the pediatric population when given by the rectal or intravenous routes (Korpela et al, 1999; Dashti et al, 2009; Hong et al, 2010).
New Formulation NCT01754116 ↗ A Randomized Study to Assess the Relative Bioavailability of New Formulations of GSK1265744 Long Acting Parental (LAP) in Healthy Adult Subjects Completed GlaxoSmithKline Phase 1 2013-01-01 This is a single-center, randomized, open-label, 3 parallel treatment study in healthy adult subjects to assess the relative bioavailability of new formulations of GSK1265744 LAP 400 mg intra muscular compared to the current GSK1265744 LAP 400 mg nanomilled formulation. This study will evaluate LAP formulations of GSK1265744 with different particle sizes. Following a 14 day lead in period with oral GSK1265744, forty-five subjects will receive 400 mg of one of three GSK1265744 formulations which vary in particle size from 200 nm to 5 um by intramuscular injection. Samples for determination of GSK1265744 concentrations will be collected for 12 weeks post-injection. Safety will be evaluated by adverse event recording and laboratory values at frequent intervals throughout the trial. A subgroup of 12 subjects will receive a 3 mg dose of oral midazolam at baseline on Day-29 and then again on the last day of the oral GSK1265744 lead in period to evaluate the effect of GSK1265744 on CYP3A enzymes. The subjects will undergo follow-up evaluations for a minimum of 12 weeks.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for MIDAZOLAM IN 0.8% SODIUM CHLORIDE

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.
NCT00006299 ↗ Celebrex for Pain Relief After Oral Surgery Completed National Institute of Dental and Craniofacial Research (NIDCR) Phase 2 1999-12-01 This study will evaluate the effects of the new anti-inflammatory drug, Celebrex, on relieving pain after oral surgery. It is also designed to assess the drug's selective inhibition of a chemical called cyclooxygenase-2 and not its closely related form, cyclooxygenase-1. This selective inhibition allows pain alleviation without the adverse side effects (e.g., bleeding and stomach upset) often associated with anti-inflammatory drugs. Healthy volunteers who require removal of their third molars are eligible for this study. Participants will have oral surgery for tooth extraction after receiving a local anesthetic (lidocaine) in the mouth and a sedative (midazolam) through an arm vein. On the evening before and 1 hour before surgery, patients will be given a dose of either the standard anti-inflammatory drug ibuprofen (Advil, Nuprin, Motrin), or Celebrex, or a placebo (a pill with no active ingredient). After surgery, a small piece of tubing will be placed in each extraction site and tied to an adjacent tooth to hold it in place. Samples will be collected from the tubing to measure chemicals involved in pain and inflammation. Patients will stay in the clinic for up to 6 hours after surgery while the anesthetic wears off and will complete pain questionnaires. During that time, they may receive acetaminophen plus codeine (Tylenol 3), if needed, for pain. The tubing then will be removed and the patient discharged with standard pain medication.
NCT00026819 ↗ Rofecoxib to Prevent Pain After Third Molar (Wisdom Tooth) Extraction Completed National Institute of Dental and Craniofacial Research (NIDCR) Phase 2 2001-11-01 This study will evaluate the ability of a new non-steroidal anti-inflammatory drug (NSAID) called rofecoxib to prevent pain following third molar (wisdom tooth) extraction. The Food and Drug Administration approved rofecoxib in 1999 to treat the symptoms of arthritis, menstrual cramps, and pain. Healthy normal volunteers between 16 and 35 years of age in general good health who require third molar (wisdom tooth) extraction may be eligible for this study. Candidates will be screened with a medical history and oral examination, including dental x-rays as needed to confirm the need for third molar removal. Participants will have all four wisdom teeth extracted, and a biopsy (removal of a small piece of tissue) will be taken from the inside of the cheek around the area behind the lower wisdom tooth. On the morning of surgery, patients will be given a dose of either the standard anti-inflammatory drug ibuprofen (Advil, Nuprin, Motrin), or rofecoxib, or a placebo (a pill with no active ingredient). Before surgery, they will be given a local anesthetic (lidocaine) in the mouth and a sedative (midazolam) through an arm vein. After the surgery, patients will remain in the clinic for up to 4 hours to monitor pain and the effects of the drug. Patients will complete pain questionnaires. Patients whose pain is unrelieved an hour after surgery may request and receive morphine intravenously (through a vein). After 4 hours, patients will be discharged with additional pain medicines (Tylenol with codeine and the study drug) and instructions for their use. They will also be given a pain diary to record pain ratings and medications taken at home. A clinic staff member will telephone patients at home the morning after surgery to ensure they are rating their pain intensity at the proper time and are taking their medications as instructed. Patients will return to the clinic 48 hours after surgery with the pain diary and pain relievers. At this visit, another biopsy will be taken under local anesthetic.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for MIDAZOLAM IN 0.8% SODIUM CHLORIDE

Condition Name

Condition Name for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Intervention Trials
Healthy 110
Anesthesia 53
Pain 53
Sedation 47
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Condition MeSH

Condition MeSH for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Intervention Trials
Pain, Postoperative 114
Delirium 42
Depression 40
Emergence Delirium 36
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Clinical Trial Locations for MIDAZOLAM IN 0.8% SODIUM CHLORIDE

Trials by Country

Trials by Country for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
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 IN 0.8% SODIUM CHLORIDE
Location Trials
Texas 105
California 98
New York 73
Florida 62
Pennsylvania 53
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Clinical Trial Progress for MIDAZOLAM IN 0.8% SODIUM CHLORIDE

Clinical Trial Phase

Clinical Trial Phase for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Clinical Trial Phase Trials
PHASE4 41
PHASE3 18
PHASE2 23
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Clinical Trial Status

Clinical Trial Status for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Clinical Trial Phase Trials
Completed 909
RECRUITING 259
Not yet recruiting 166
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Clinical Trial Sponsors for MIDAZOLAM IN 0.8% SODIUM CHLORIDE

Sponsor Name

Sponsor Name for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Sponsor Trials
Boehringer Ingelheim 35
Ain Shams University 34
Pfizer 31
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Sponsor Type

Sponsor Type for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Sponsor Trials
Other 1665
Industry 577
NIH 52
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MIDAZOLAM IN 0.8% SODIUM CHLORIDE: Clinical Trials Update, Market Analysis, and 2024-2034 Projection

Last updated: April 26, 2026

Midazolam in 0.8% sodium chloride is an established, IV-ready benzodiazepine product used for procedural sedation and peri-procedural anxiolysis. Market performance is primarily tied to hospital sedation demand, intensive care utilization, and guideline-driven substitution between midazolam formulations (IV bolus, infusion, and alternatives within the benzodiazepine class). Clinical pipeline activity is most concentrated in improved presentation formats (concentration, packaging, and stability) and in line-extension trials rather than new midazolam active moieties.

What is the product and where does it sit in the sedation landscape?

Midazolam is a short-acting benzodiazepine with anxiolytic, sedative, and anticonvulsant activity. “Midazolam in 0.8% sodium chloride” describes a specific aqueous IV formulation at the level of excipient composition rather than a distinct pharmacologic entity.

Use case clusters driving demand

Cluster Typical setting Clinical role Budget sensitivity driver
Procedural sedation Endoscopy, interventional radiology, emergency department Acute sedation with titration Per-session drug cost plus staffing and throughput
ICU sedation Mechanical ventilation, agitation Sedation as part of protocolized care Formulary preference and nursing workflow
Status epilepticus / seizure control ED, ICU Adjunct benzodiazepine for acute seizure Time-to-treatment and availability

Formulation economics: why “0.8% sodium chloride” matters

Hospitals buy at the level of “ready-to-administer IV product” and center pharmacy selection on:

  • stability and shelf life under cold-chain requirements (if any),
  • compatibility for Y-site administration and co-infusion,
  • packaging convenience for rapid titration,
  • and formulary alignment for controlled substances and audit requirements.

What do recent clinical trials show for midazolam IV formulations?

No new midazolam base molecule trials are required to sustain the category; activity is usually driven by:

  • safety and usability studies for a specific formulation strength,
  • pharmacokinetic bridging across presentations,
  • pediatric and procedural subpopulations,
  • and comparative effectiveness in sedation protocols.

Trial update: category signal

Across midazolam sedation and seizure indications, the last decade of evidence is dominated by:

  • routine randomized sedation comparisons (midazolam versus propofol or other sedatives),
  • protocolized titration studies,
  • and safety/feasibility trials in specific populations (pediatrics, ICU, endoscopy).

For a formulation defined by excipient composition (0.8% sodium chloride), the practical clinical question for payers and providers is not “does midazolam work,” but whether the presentation improves:

  • administration workflow,
  • time-to-sedation,
  • and tolerability (local tolerability, emesis risk with procedural cohorts, and respiratory depression management in dose titration).

What to expect in regulatory-style trial endpoints for formulation line extensions

Typical endpoints that support a formulation change for IV midazolam include:

  • pharmacokinetics (Cmax, Tmax, AUC) against a reference product,
  • compatibility/safety with common infusion fluids,
  • local tolerability at injection site,
  • and adverse event profiles focused on respiratory depression, hypotension, and oversedation in titrated settings.

Where is the market today, and what is the competitive map?

Midazolam is an off-patent, multi-source generic category in most markets. “Midazolam in 0.8% sodium chloride” should be treated commercially as a presentation-level product competing on:

  • bottle/vial format,
  • concentration,
  • shelf life,
  • and distribution reliability for controlled-substance procurement.

Competitive landscape (by competition type)

Competition type How it substitutes Impact on pricing
Same active, different IV presentation (concentration/pack) Pharmacy substitution with therapeutic equivalence Drives tender-based price compression
Same indication, different sedative class (propofol, dexmedetomidine, ketamine, etc.) Protocol-level sedative selection Can shift share in procedural sedation
Same active, alternate benzodiazepines (lorazepam, diazepam) Less common for IV titration protocols Moderates competition but limited penetration in ICU sedation

Demand drivers that sustain midazolam volume

  1. Endoscopy and interventional imaging volumes.
  2. ICU occupancy and mechanical ventilation prevalence.
  3. Continued use of benzodiazepines in acute seizure management protocols.
  4. Guideline continuity: midazolam remains a standard sedative and adjunct anticonvulsant in multiple care pathways.

Procurement mechanics that influence revenues

Midazolam IV products are typically sold into hospital supply chains under:

  • competitive tenders,
  • group purchasing organization (GPO) contracts,
  • and pharmacy inventory stocking for controlled drugs.

As a result, revenue growth tends to track:

  • unit volume (procedures and ICU days),
  • tender price effects (often negative over time),
  • and product availability (stockouts can cause short-term displacement, then reversal).

2024-2034 market projection: how the category is likely to evolve

The projection below reflects a presentation-level midazolam product inside an off-patent, high-volume sedation and acute care category. The baseline assumption is a mature market with price erosion and stable-to-modest volume growth.

Scenario framework

  • Base case: modest unit growth with ongoing generic price erosion and some share stability due to formulary inertia.
  • Downside: accelerated price erosion from tender escalation plus substitution to non-benzodiazepine protocols in procedural sedation.
  • Upside: expanded ICU sedation intensity and higher procedural volumes offset pricing declines.

Regional and channel logic

  • Hospitals drive most volume.
  • Retail penetration is minimal for IV formulations.
  • Asia and emerging markets contribute disproportionate unit growth due to expanding hospital capacity, but pricing pressure remains high due to generic competition.

Projection table (category-level, presentation economics apply)

Because the specific “0.8% sodium chloride” presentation typically tracks the broader midazolam IV category, the projection is expressed as category revenue growth rates for the presentation class.

Year Base case revenue growth (category) Expected direction Key forces
2024 +1% to +3% Slow growth Volume growth offsets mild price erosion
2025 +0% to +2% Flat to low Tender pressure increases
2026 +0% to +2% Low Mix shift across ICU vs procedural
2027 +1% to +3% Re-accelerate Procedure volumes recover; supply normalizes
2028-2030 +0% to +2% Plateau Generic price compression dominates
2031-2034 +0% to +1% Slight growth Stabilization of price and volumes

Implication for a specific presentation product: revenue is most sensitive to contracting cycles and substitution within hospital formularies. The “0.8% sodium chloride” attribute influences adoption mainly through procurement convenience, stability, and compatibility rather than differentiation in clinical outcomes.

What could move share for “MIDAZOLAM IN 0.8% SODIUM CHLORIDE”?

Share levers

Lever Mechanism Likely impact
Tender placement (GPO contracts) Inclusion in preferred drug list High impact on volume
Stock reliability Avoids substitution during shortage Temporary gains can persist if outcomes are stable
Packaging and administration workflow Fast preparation, clear labeling Clinically neutral but operationally meaningful
Protocol shifts in sedation Growing use of dexmedetomidine or propofol in some settings Can reduce procedural sedation benzodiazepine share
Pediatric and ICU updates Continued benzodiazepine use in protocols Stabilizes baseline demand

Risk profile

  • Pricing risk: persistent downward pressure from multi-source generics.
  • Utilization risk: protocol shifts away from benzodiazepines in procedural sedation where alternative sedatives gain preference.
  • Supply risk: regulated substance logistics affect availability, which can swing short-term volume.

Business implications for R&D, investment, and lifecycle strategy

For R&D teams

If the formulation is already established, the most viable “defensive” value is in:

  • stability and shelf-life improvements,
  • packaging improvements that reduce time-to-preparation,
  • and compatibility studies for common co-administered IV fluids.

Clinical novelty is rarely required because the active molecule is mature; the value lies in operational differentiation and contract readiness.

For investors and commercial teams

Expect value capture to come from:

  • supply reliability and contract wins,
  • differentiation through low-friction hospital procurement,
  • and minimizing tender losses by maintaining consistent logistics.

A midazolam presentation is typically more “execution driven” than “innovation driven.”

Key Takeaways

  • Midazolam in 0.8% sodium chloride is a mature IV sedation and acute care benzodiazepine presentation where commercial outcomes hinge on hospital contracting, supply reliability, and substitution dynamics.
  • Clinical evidence for midazolam as a class is established; formulation-specific trials generally focus on bridging, safety, and administration usability rather than new efficacy.
  • The 2024-2034 outlook is mostly flat-to-modest growth with ongoing price erosion in an off-patent, multi-source market; share is won in tenders and preferred formulary placement rather than by clinical differentiation alone.

FAQs

1) Is “midazolam in 0.8% sodium chloride” a new active ingredient?

No. It is a formulation variant that uses the established midazolam active.

2) What clinical outcomes matter most for a formulation line extension?

Pharmacokinetics/bridging, safety (including respiratory depression risk management in titrated sedation), and administration usability compatibility are typically the decision drivers.

3) What is the main market driver: procedures or ICU?

Both matter; ICU days and mechanical ventilation prevalence tend to provide steadier baseline demand, while procedural volumes drive peaks.

4) How does generic competition affect pricing?

It compresses prices through tenders and multi-source procurement, leading to low or modest category revenue growth despite unit volume stability.

5) What factors most influence hospital adoption?

Preferred formulary status, tender award outcomes, shelf-life and supply reliability, and workflow fit for nursing and pharmacy.


References

[1] U.S. National Library of Medicine. Midazolam. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Midazolam
[2] National Center for Biotechnology Information. Midazolam (drug information and pharmacology summaries). https://www.ncbi.nlm.nih.gov/
[3] World Health Organization. Benzodiazepines and sedation-related clinical guidance (general category resources). https://www.who.int/

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