In pediatric patients experiencing seizures, what is the maximum IM/IN midazolam dose for a single administration?

• A. 5 mg
• B. 2.5 mg
• C. 10 mg
• D. 1 mg

Answer: (A)

In pediatric seizure management, midazolam is given at a weight-based dose per administration, with a safety cap. The dose is 0.2 mg/kg for each IM or intranasal administration, but you do not exceed 5 mg in a single dose. This ceiling protects against oversedation and respiratory depression while still aiming for rapid seizure control. So you calculate the child’s weight, multiply by 0.2 mg/kg, and use the smaller of that result or 5 mg. For example, a 25 kg child would receive 5 mg (0.2 mg/kg × 25 kg = 5 mg), while a lighter child might receive less, and a heavier child would also be limited to 5 mg per dose. If seizures persist, administer additional doses only per protocol with appropriate monitoring and airway support.