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Clinical data
Trade namesByfavo
Other namesCNS-7056[1]
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Molar mass439.313 g·mol−1
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Remimazolam, sold under the brand name Byfavo, is a medication for the induction and maintenance of procedural sedation in adults lasting 30 minutes or less.[2] is a benzodiazepine derivative drug, developed by PAION, in collaboration with Japanese licensee Ono Pharmaceutical as an alternative to the short-acting imidazobenzodiazepine midazolam, for use in induction of anaesthesia and conscious sedation for minor invasive procedures. Remimazolam was found to be both faster acting and shorter lasting than midazolam, and human clinical trials showed a faster recovery time and predictable, consistent pharmacokinetics, suggesting some advantages over existing drugs for these applications.[3][4]

The most common side effects for procedural sedation include hypotension, hypertension, diastolic hypertension, systolic hypertension, hypoxia, and diastolic hypotension.[2]

Remimazolam was approved for medical use in the United States in July 2020.[2]

Medical uses[edit]

Remimazolam is indicated for the induction and maintenance of procedural sedation in adults lasting 30 minutes or less.[2][5]


Phase I[6] and Ib[7] dose-finding studies for procedural sedation with patients recovering faster from remimazolam than midazolam. Phase II trials comparing remimazolam to the standard anesthesia protocols for cardiac surgery and colonoscopy were presented at major conferences in October 2014.[8]

A Phase IIa trial comparing remimazolam to midazolam for upper endoscopy was published in December 2014, finding a similar safety profile.[9] Remimazolam was originally discovered in the late 1990s at Glaxo Wellcome in their labs in Research Triangle Park, NC.

See also[edit]


  1. ^ Kilpatrick, Gavin J.; McIntyre, Margaret S.; Cox, Richard F.; Stafford, Jeffrey A.; Pacofsky, Gregory J.; Lovell, Gwyer G.; Wiard, Robert P.; Feldman, Paul L.; Collins, Holly; Waszczak, Barbara L.; Tilbrook, Gary S. (July 2007). "CNS 7056: a novel ultra-short-acting Benzodiazepine". Anesthesiology. 107 (1): 60–66. doi:10.1097/01.anes.0000267503.85085.c0. ISSN 0003-3022. PMID 17585216.
  2. ^ a b c d "Cosmo Pharmaceuticals Announces US FDA Approval of Byfavo (remimazolam injection) for the Induction and Maintenance of Procedural Sedation". Cosmo Pharmaceuticals NV (Press release). 2 July 2020. Retrieved 2 July 2020.
  3. ^ Rogers WK, McDowell TS (December 2010). "Remimazolam, a short-acting GABA(A) receptor agonist for intravenous sedation and/or anesthesia in day-case surgical and non-surgical procedures". IDrugs : The Investigational Drugs Journal. 13 (12): 929–37. PMID 21154153.
  4. ^ Saari TI, Uusi-Oukari M, Ahonen J, Olkkola KT (March 2011). "Enhancement of GABAergic activity: neuropharmacological effects of benzodiazepines and therapeutic use in anesthesiology". Pharmacological Reviews. 63 (1): 243–67. doi:10.1124/pr.110.002717. PMID 21245208.
  5. ^ "Byfavo: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 2 July 2020.
  6. ^ Antonik, Laurie J.; Goldwater, D. Ronald; Kilpatrick, Gavin J.; Tilbrook, Gary S.; Borkett, Keith M. (Aug 2012). "A placebo- and midazolam-controlled phase I single ascending-dose study evaluating the safety, pharmacokinetics, and pharmacodynamics of remimazolam (CNS 7056): Part I. Safety, efficacy, and basic pharmacokinetics". Anesthesia and Analgesia. 115 (2): 274–83. doi:10.1213/ANE.0b013e31823f0c28. PMID 22190555.
  7. ^ Worthington, Mark T.; Antonik, Laurie J.; Goldwater, D. Ronald; Lees, James P.; Wilhelm-Ogunbiyi, Karin; Borkett, Keith M.; Mitchell, Mack C. (Nov 2013). "A phase Ib, dose-finding study of multiple doses of remimazolam (CNS 7056) in volunteers undergoing colonoscopy". Anesthesia & Analgesia. 117 (5): 1093–100. doi:10.1213/ANE.0b013e3182a705ae. PMID 24108261.
  8. ^ "Two Scientific Remimazolam Presentations Are Accepted for ASA and ACG Meeting in October 2014". MarketWired. Oct 1, 2014. Retrieved 2014-10-24.
  9. ^ Borkett, Keith M.; Riff, Dennis S.; Schwartz, Howard I.; Winkle, Peter J.; Pambianco, Daniel J.; Lees, James P.; Wilhelm-Ogunbiyi, Karin (Dec 11, 2014). "A Phase IIa, Randomized, Double-Blind Study of Remimazolam (CNS 7056) Versus Midazolam for Sedation in Upper Gastrointestinal Endoscopy". Anesthesia & Analgesia. 120 (4): 771–80. doi:10.1213/ANE.0000000000000548. PMID 25502841.

External links[edit]

  • "Remimazolam". Drug Information Portal. U.S. National Library of Medicine.