Midazolam Shortage Update: What Patients Need to Know in 2026

If you rely on midazolam — whether as an injectable sedative, an oral syrup for a child's procedure, or the Nayzilam nasal spray for seizure rescue — staying informed about supply status is critical. This article breaks down the current midazolam shortage situation, what has caused past supply disruptions, and what steps you can take right now to protect your access to this medication.

Is Midazolam in Shortage in 2026?

As of early 2026, midazolam is not listed on the FDA's active drug shortage database. This is good news — it means there is no declared nationwide supply crisis for any midazolam formulation at this time. However, this does not mean every pharmacy has every formulation in stock. Localized supply gaps, stocking variability between pharmacies, and the specialty nature of certain forms (particularly Nayzilam nasal spray and the oral syrup) mean that individual patients can still face difficulty filling prescriptions.

Midazolam Shortage History: What Happened in the Past?

Midazolam injectable has a documented history of appearing on the FDA shortage database, primarily driven by the inherent vulnerabilities of sterile injectable drug manufacturing. Key historical events include:

2020 COVID-19 pandemic: Demand for ICU sedatives, including midazolam, surged dramatically as hospitals treated record numbers of critically ill patients on ventilators. This placed enormous strain on the entire benzodiazepine injectable supply chain.

2022-2023 IV lorazepam shortage: When IV lorazepam (Ativan) experienced a nationwide shortage, many hospitals and clinicians substituted midazolam, unexpectedly increasing demand and creating localized midazolam shortages as well.

Sterile injectable manufacturing fragility: With a limited number of manufacturers producing injectable midazolam, a quality issue or production halt at a single facility can remove a large percentage of national supply.

Which Midazolam Formulations Are Most at Risk?

Not all midazolam formulations face the same availability challenges:

Injectable vials (1 mg/mL, 5 mg/mL): Most likely to experience national shortages due to sterile manufacturing complexity and high hospital demand

Nayzilam nasal spray: Available from a single manufacturer (UCB); not widely stocked at retail pharmacies, which means individual patients may face access challenges even without a formal shortage

Oral syrup (2 mg/mL): Niche product not commonly stocked at all pharmacies; compounding may be an option when commercial supply is limited

What Are the Warning Signs of a Shortage Affecting You?

Multiple pharmacies tell you they don't have it in stock and don't know when they will

Your pharmacy tells you the wholesaler is on backorder for your specific midazolam product

You receive a notice from UCB about Nayzilam supply constraints

The FDA adds midazolam to its active shortage database at ashp.org or the FDA drug shortages page

What Should Patients Do Right Now?

Even without a declared shortage, patients who depend on midazolam for seizure rescue should take proactive steps:

Keep at least one full supply on hand. Don't wait until you are completely out of Nayzilam or other midazolam products to refill.

Know your backup plan. Discuss with your neurologist what alternative seizure rescue medication you would use if midazolam became unavailable.

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Monitor the FDA shortage database at fda.gov/drugs/drug-shortages for official updates.

If you are currently having trouble finding midazolam, medfinder.com can help by contacting pharmacies near you on your behalf to find which ones have it in stock.

Resources for Monitoring Midazolam Availability

See also: How to Find Midazolam in Stock Near You for practical tips on locating your medication.