Side Effects and Contraindications

Benzodiazepines are remarkably safe drugs. They have a relatively high margin of safety, especially when compared with barbiturates. They are also free of allergenic effects and do not suppress the adrenal gland.^[414] The most significant problem with midazolam is respiratory depression. The major side effects of lorazepam and diazepam, in addition to respiratory depression, are venous irritation and thrombophlebitis, problems related to aqueous insolubility and the requisite solvents.^[359] When used as sedatives or for induction and maintenance of anesthesia, benzodiazepines can produce an undesirable degree or a prolonged interval of postoperative amnesia, sedation, and rarely, respiratory depression. These residual effects can be reversed with flumazenil.