Although midazolam does not require to be kept in a locked CD cabinet or documented in a CD register, it is subject to restrictions with respect to ordering, prescription writing and denaturing. In addition, it is an offence to be in possession of midazolam unless exempted under the Misuse of Drugs Regulations 2001 [1]. Dentists are legally entitled to be in possession of CDs, but must have standard operating procedures and adequate controls in place to cover all aspects of the use of midazolam and to prevent it falling into the possession of someone who does not have these legal rights. The same requirements apply whether midazolam is kept in buccal liquid form or as an injection solution.
Appoint a dentist to have overall responsibility for midazolam and know how to contact your local Controlled Drugs Accountable Officer (CDAO).
Have in place a Controlled Drug Standard Operating Procedure template that covers all aspects of the management of midazolam (obtaining, recording, security, storage, denaturing etc.) and describes the responsibilities of individuals [2].
Keep midazolam for use in medical emergencies with other emergency drugs so that they can be easily accessed in an emergency.
In practices that are set up to provide conscious sedation, keep midazolam in appropriate storage facilities i.e. locked cupboard.
If midazolam is used to provide conscious sedation, ensure that appropriate antagonist injection is available (i.e. flumazenil).