The Present and Future of Remimazolam in the Intensive Care Unit

Abstract

Remimazolam, a novel benzodiazepine, is a drug with distinctive pharmacological properties including low circulatory inhibition and a short-acting drug profile, and it has attracted attention for its usefulness. Remimazolam has the potential to overcome the disadvantages of conventional benzodiazepines such as prolonged sedation and increased risks of delirium. A clinical trial was conducted to support the approval of remimazolam for use as a sedative during ventilation in the critical care setting（ONO-2745-04）. The trial was aborted because of delayed arousal and hyper-escalation of plasma concentrations in patients receiving continuous dosing for more than 24 hours. However, research on remimazolam in the intensive care setting continues, and new findings are being gathered. We would like to discuss how remimazolam can be used effectively in the intensive care unit.