Last Updated: May 14, 2026

CLINICAL TRIALS PROFILE FOR MIDAZOLAM IN 0.9% SODIUM CHLORIDE


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505(b)(2) Clinical Trials for MIDAZOLAM IN 0.9% 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 A new formulation of S-ketamine as an intranasal spray device was tested in our hospital in 8 healthy volunteers (unpublished data, EKBB 351/08). 20 mg of S-ketamine were administered intranasally and compared with S-ketamine i.v. and i.m..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).
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for MIDAZOLAM IN 0.9% 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.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for MIDAZOLAM IN 0.9% SODIUM CHLORIDE

Condition Name

Condition Name for MIDAZOLAM IN 0.9% SODIUM CHLORIDE
Intervention Trials
Healthy 110
Anesthesia 53
Pain 53
Sedation 47
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Condition MeSH

Condition MeSH for MIDAZOLAM IN 0.9% SODIUM CHLORIDE
Intervention Trials
Pain, Postoperative 114
Delirium 42
Depression 40
Emergence Delirium 36
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Clinical Trial Locations for MIDAZOLAM IN 0.9% SODIUM CHLORIDE

Trials by Country

Trials by Country for MIDAZOLAM IN 0.9% 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 0.9% 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 0.9% SODIUM CHLORIDE

Clinical Trial Phase

Clinical Trial Phase for MIDAZOLAM IN 0.9% 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 0.9% SODIUM CHLORIDE
Clinical Trial Phase Trials
COMPLETED 909
Recruiting 259
Not yet recruiting 166
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Clinical Trial Sponsors for MIDAZOLAM IN 0.9% SODIUM CHLORIDE

Sponsor Name

Sponsor Name for MIDAZOLAM IN 0.9% SODIUM CHLORIDE
Sponsor Trials
Boehringer Ingelheim 35
Ain Shams University 34
Pfizer 31
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Sponsor Type

Sponsor Type for MIDAZOLAM IN 0.9% SODIUM CHLORIDE
Sponsor Trials
Other 1665
Industry 577
NIH 52
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Midazolam in 0.9% Sodium Chloride: Clinical Trials Update, Market Analysis, and Projection

Last updated: May 5, 2026

What is the product category: “midazolam in 0.9% sodium chloride”?

“Midazolam in 0.9% sodium chloride” is a marketed parenteral formulation of the benzodiazepine midazolam delivered in an isotonic saline diluent (0.9% NaCl). In practice, this maps to common hospital-use presentations used for procedural sedation, anesthesia induction support, ICU sedation, and rapid-acting control of acute agitation or seizures depending on regional labeling. Commercially, these products compete within the broader parenteral sedative and anxiolytic segment, with product differentiation driven by concentration, container type (typically prefilled syringe or vial), stability claims, and regulatory status in each market.

From a regulatory and clinical-trial standpoint, midazolam is a long-established active ingredient, so “midazolam in 0.9% NaCl” trials tend to be formulation, administration method, or regimen-focused rather than new-molecular-entity programs.

What is the clinical-trials update for midazolam in 0.9% sodium chloride?

Search result logic (trial visibility)

For an established drug substance like midazolam, the clinical-trials landscape is dominated by:

  • formulation comparisons (vehicle, concentration, container, delivery device)
  • pharmacokinetic (PK) and pharmacodynamic (PD) bridging
  • administration routes and sedation endpoints (e.g., onset, duration, rescue dosing)
  • special populations (pediatrics, geriatrics, hepatic or renal impairment)

Trial activity: what is observable at registry level

A complete, current “midazolam in 0.9% sodium chloride” trial register pull is not available in this response because no specific trial dataset or registry query results were provided in the prompt. Under the constraints, no partial or inferred trial counts can be stated without a verifiable source snapshot.

Practical implication for decision-makers

Treat “clinical trials update” for this exact formulation as a continuation of established midazolam use rather than a high-NDA wave. The only “update” that can be stated with precision is that ongoing registries typically show formulation or administration-focused studies, while label expansions are most common through variations of route, setting, and dosing rather than through new diluent systems for midazolam.

How does the market size and demand profile work for midazolam-saline products?

Market positioning

Midazolam is one of the most used IV sedatives globally. The saline-containing presentation is a packaging and formulation detail within an entrenched therapeutic class.

Demand drivers:

  • procedural sedation volumes in emergency departments, endoscopy units, and operating rooms
  • ICU sedation protocols
  • anesthesia induction support
  • seizure and status epilepticus treatment pathways (route-dependent)
  • inventory standardization in hospitals (formulary preference, pack-outs, and stability)

Competitive set

Competition typically comes from:

  • other IV midazolam presentations (different concentrations, devices, or container formats)
  • alternative benzodiazepines or sedatives depending on region and setting (agent-specific substitution)
  • sedation protocols that mix or sequence agents (midazolam as part of multi-drug pathways)

Pricing and procurement dynamic

For established generics, procurement typically tracks:

  • tender pricing and contract manufacturing availability
  • pack size and dosing convenience (prefilled vs vial)
  • perceived readiness for emergency use (time to draw, dilution requirements, and labeling)

What is the forecast outlook for midazolam in 0.9% sodium chloride?

Base case projection logic

Because midazolam is off-patent in most jurisdictions, the forecast is primarily a function of:

  • procedural and ICU bed utilization growth
  • replacement demand due to hospital tender cycles
  • substitution risk versus alternative sedatives
  • price compression and margin pressure typical of mature generics

What can be projected credibly here

A numeric market-size forecast (TAM/SAM/SOM in USD or units) requires a specific market dataset and a mapping of product definition to database categories (for example, ATC code mapping, local NDC-level mapping, or IMS-style segment definitions). No such dataset was provided, and the constraints prohibit inference without sources.

Accordingly, this response does not state a numerical projection.

Regulatory and evidence considerations that influence adoption

Label-driven use patterns

In mature therapies, adoption is driven more by:

  • label alignment with sedation and ICU protocols
  • guideline adherence and hospital formulary governance
  • pharmacovigilance history and clinician familiarity

Formulation relevance

The “0.9% NaCl” diluent matters operationally:

  • compatibility with infusion workflows
  • ease of administration without requiring patient-specific dilution steps
  • standardization across wards and emergency carts

Business implications: where value is created

1) Container and administration workflow

For hospital users, the key differentiators that sustain share in a mature active-ingredient market are:

  • minimized handling steps (prefilled formats)
  • dosing accuracy and reduced waste
  • stability claims aligned to real-world storage and prep practices

2) Contracting and supply reliability

With generics, market share is often won through:

  • tender inclusion (formulary and contracting)
  • consistent supply and lot availability
  • packaging that reduces draw-up time and administration errors

3) Pharmacoeconomics via protocol fit

Even when midazolam is clinically interchangeable across formulations, procurement often selects the product that best fits:

  • sedation order sets
  • nursing workflow in ED/ICU/endoscopy
  • compatibility with common infusion systems

Key Takeaways

  • “Midazolam in 0.9% sodium chloride” is a mature, formulation-level variant within an established IV benzodiazepine market.
  • Clinical-trials activity, when present, typically focuses on formulation, PK/PD bridging, and administration workflow rather than new mechanism development.
  • Market dynamics are procurement-driven (tenders, supply reliability, pack convenience) and price-compression-driven due to generic competition.
  • A numeric market size and forecast projection cannot be stated here without a cited market dataset mapped to this exact formulation definition.

FAQs

  1. Is midazolam in 0.9% sodium chloride a distinct drug versus midazolam injection?
    It is the same active ingredient delivered in an isotonic saline diluent; differentiation is mainly formulation and packaging.

  2. Why do formulation trials matter for established midazolam?
    They support switching, administration workflow improvements, and regulatory acceptance for specific containers, concentrations, and clinical settings.

  3. What most influences hospital adoption for this product?
    Contract placement, supply continuity, and ease of administration that aligns with sedation protocols.

  4. Does clinical evidence change faster than market share for mature sedatives?
    Usually not. For established drugs, real-world uptake often follows procurement and protocol fit more than new efficacy data.

  5. What is the main risk to share in this category?
    Price compression and substitution within sedation regimens, including alternative sedatives and other midazolam presentations.


References

[1] Drugs@FDA. (n.d.). Midazolam (product and labeling information). U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cder/daf/
[2] DailyMed. (n.d.). Midazolam injection (sodium chloride, 0.9%) labeling and product details. U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/
[3] ClinicalTrials.gov. (n.d.). Midazolam studies and records. U.S. National Library of Medicine. https://clinicaltrials.gov/

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