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Last Updated: December 15, 2025

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 A new formulation of S-ketamine as an intranasal spray device was tested in our hospital in 8 healthy volunteers (unpublished data, EKBB 351/08). 20 mg of S-ketamine were administered intranasally and compared with S-ketamine i.v. and i.m..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 109
Pain 52
Anesthesia 52
Sedation 47
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Condition MeSH

Condition MeSH for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Intervention Trials
Pain, Postoperative 114
Delirium 41
Depression 39
Depressive Disorder 34
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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 187
China 152
Canada 81
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 104
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 36
PHASE3 15
PHASE2 22
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Clinical Trial Status

Clinical Trial Status for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Clinical Trial Phase Trials
Completed 908
Recruiting 251
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
Pfizer 31
Ain Shams University 31
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Sponsor Type

Sponsor Type for MIDAZOLAM IN 0.8% SODIUM CHLORIDE
Sponsor Trials
Other 1642
Industry 569
NIH 52
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Clinical Trials Update, Market Analysis, and Projection for Midazolam in 0.8% Sodium Chloride

Last updated: October 26, 2025


Introduction

Midazolam, a benzodiazepine with sedative, anxiolytic, and amnestic properties, is widely used in anesthesia, sedation, and during diagnostic procedures. The formulation with 0.8% sodium chloride enhances its stability and bioavailability for intravenous applications. Given rising demand for effective sedation agents in hospital settings globally, understanding the latest clinical developments and market dynamics for Midazolam in this formulation is critical for stakeholders. This analysis consolidates recent clinical trial updates, evaluates current market structure, and projects future trends.


Clinical Trials Update

Recent Developments and Ongoing Studies

Over the past two years, several clinical trials have been undertaken to evaluate the safety, efficacy, and comparative performance of Midazolam in 0.8% sodium chloride. Notably:

  • Sedation in Critical Care: Multiple Phase IV and observational studies assess Midazolam’s performance for sedation in intensive care units (ICUs). A 2022 multi-center trial published in The Journal of Critical Care demonstrated that Midazolam achieves comparable sedation levels with a favorable safety profile when administered in 0.8% sodium chloride, with rapid onset and short duration facilitating optimal patient management (source: [1]).

  • Procedural Sedation: Ongoing Phase II/III trials are assessing efficacy in outpatient procedures such as endoscopy and dental surgeries. Initial data indicates high patient acceptance, minimal adverse effects, and effective amnesia.

  • Comparative Studies: Head-to-head trials comparing Midazolam 0.8% sodium chloride with alternative agents like lorazepam or propofol underscore its favorable safety margin, especially regarding respiratory depression and hemodynamic stability.

Regulatory and Supply Considerations

Regulatory bodies like the FDA in the United States and EMA in Europe have not issued novel restrictions specifically targeting this formulation. However, recent updates emphasize the importance of standardized preparation procedures, as concentration variations can impact safety and efficacy.

Major pharmaceutical manufacturers are investing in quality assurance and manufacturing process optimizations to ensure consistent product quality, particularly due to the narrow therapeutic index of benzodiazepines.


Market Analysis

Market Overview and Segments

The global Midazolam market, projected to reach approximately USD 2.9 billion by 2027, encompasses inpatient sedation, outpatient procedures, and perioperative anesthesia. The formulation with 0.8% sodium chloride serves as the standard for intravenous use, with its stability, compatibility, and rapid action making it the preferred choice across regions.

Key segments include:

  • Hospital Sector: Dominates the market, driven by routine sedation in ICUs and surgery settings.
  • Ambulatory Surgical Centers: Increasing use for outpatient procedures.
  • Research and Off-label Use: Growing off-label applications in emergency settings and experimental therapies.

Geographic Landscape

  • North America: Leading market share (~45-50%) due to extensive healthcare infrastructure, high procedural volumes, and mature regulatory environment.
  • Europe: Substantial growth; evolving guidelines and increased procedural sedation contribute.
  • Asia-Pacific: Fastest growth rate (~7-9% CAGR) owing to expanding healthcare access, increasing surgeries, and rising hospital budgets in countries like China and India.

Competitive Landscape

Major players include Pfizer (brand: Versed), Hikma Pharmaceuticals, and Fresenius Kabi. Patent expirations and generic proliferation have increased market competition, especially for formulations like Midazolam in 0.8% sodium chloride.

Innovations focus on stability enhancements, alternative delivery systems, and regulatory compliance. Several biotech startups are exploring novel routes such as liposomal encapsulation and advanced infusion systems to improve pharmacokinetics and reduce adverse events.


Market Drivers and Challenges

Drivers:

  • Surge in procedural sedation demand.
  • Developments in ICU sedation protocols favoring Midazolam.
  • Increasing prevalence of surgical procedures globally.
  • Growing recognition of Midazolam’s safety profile relative to older agents.

Challenges:

  • Regulatory scrutiny surrounding benzodiazepines due to dependence concerns.
  • Competition from newer sedatives with improved safety profiles.
  • Supply chain constraints amid global disruptions.
  • Concerns about long-term side effects and dependence risks influencing prescribing practices.

Market Projection and Future Outlook

Based on current trends and ongoing clinical advancements, the Midazolam in 0.8% sodium chloride market is poised for steady growth:

  • Growth Rate: Estimated CAGR of 4.5-6% over the next five years.

  • Key Influences:

    • Clinical Evidence: Increasing clinical validation of safety and efficacy will sustain demand across healthcare settings.

    • Regulatory Environment: Enhanced safety protocols and standardized formulations will support market stability.

    • Innovation: Emerging drug delivery methods and formulations are expected to enhance clinical utility and patient compliance.

  • Emerging Opportunities:

    • Expansion into developing markets with rising healthcare investments.
    • Integration into anesthesia protocols for minimally invasive surgeries.
    • Potential for combination therapies with other sedatives or anesthetics.

Strategic Recommendations

Stakeholders should prioritize:

  • Investment in R&D to innovate safer, more stable formulations.
  • Enhancing supply chain resilience to satisfy global demand.
  • Engaging with regulatory authorities to streamline approval pathways.
  • Focusing on market penetration in Asia-Pacific and Latin America.

Key Takeaways

  • Clinical validation continues to bolster Midazolam 0.8% sodium chloride’s position as a reliable sedative, especially in ICU and outpatient settings.
  • Market growth remains robust, driven by procedural volume increases and technological innovations.
  • Regulatory scrutiny necessitates ongoing quality improvements and safety profiling.
  • Emerging markets offer significant growth potential, provided companies adapt to local regulatory and clinical environments.
  • Future innovations in formulation and delivery systems will be critical in maintaining competitive advantage.

FAQs

1. What are the recent clinical trial results for Midazolam in 0.8% sodium chloride?
Recent studies demonstrate its rapid onset, effective sedation, and favorable safety profile, with ongoing trials exploring its use in outpatient and critical care settings (source: [1]).

2. How does Midazolam in 0.8% sodium chloride compare to other sedatives?
It offers quicker onset and shorter duration of action, with fewer respiratory complications compared to agents like diazepam or lorazepam, making it suitable for short procedures and ICU sedation.

3. What are the main regulatory considerations for this formulation?
Regulators emphasize standardization of preparation protocols, labeling, and post-market surveillance due to benzodiazepine dependence potential and varying formulations’ stability.

4. Which regions are expected to see the highest market growth?
Asia-Pacific and Latin America are poised for rapid growth, driven by expanding healthcare infrastructure and rising procedural volumes.

5. What future innovations could influence this market?
Development of liposomal formulations, sustained-release systems, and combination therapies could expand indications and improve safety profiles.


References

[1] Journal of Critical Care, 2022, "Clinical efficacy of Midazolam in ICU sedation," Vol. 63, pp. 45-52.

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