Generic
Midazolam
Brand Name
Versed
Import ID
235
Midazolam
| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Lenacapavir Midazolam 1 | Yellow: Adjust dosing | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased sedation |
Not reported |
2.5 mg orally x 1 with food, administered 1 day after LEN | AUC increased 308%; Cmax increased 116%. AUC for 1-hydroxy metabolite decreased 16%. |
If co-administering, monitor for excess sedation and adjust dose accordingly |
| Lenacapavir Midazolam | Yellow: Adjust dosing | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased sedation |
Not reported |
2.5 mg orally x 1, administered simultaneously with LEN | AUC increased 259%; Cmax increased 94%. AUC for 1-hydroxy metabolite decreased 24%. |
If co-administering, monitor for excess sedation and adjust dose accordingly |
| Ritonavir Midazolam 1104 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased midazolam effects (eg, increased sedation, confusion, respiratory depression) |
Not studied |
Not studied (may increase midazolam levels) |
Parenteral midazolam can be used with caution when given as a single dose in a monitored situation for procedural sedation. Chronic midazolam administration (oral or intravenous) should be avoided. |
|
| Darunavir Midazolam 988 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential for increased risk of midazolam adverse effects (e.g. increased sedation, confusion, respiratory depression) |
Parenteral midazolam can be used with caution when given as a single dose in a monitored situation for procedural sedation; chronic midazolam administration (oral or intravenous) is contraindicated |
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| Atazanavir Midazolam 861 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Potential for increased midazolam effects (eg, increased sedation, confusion, respiratory depression) |
Parenteral midazolam can be used with caution when given as a single dose in a monitored situation for procedural sedation. Chronic midazolam administration (oral or intravenous) should be avoided. |
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| Tenofovir alafenamide Midazolam 709 | Green: Administer standard doses | Administer standard doses | Not studied |
2.5mg once daily (PO); 1mg once daily (IV) | midazolam (2.5mg PO): Cmax increased 2%, AUC increased 12%; midazolam (1mg IV): Cmax decreased 1%, AUC increased 8% |
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| Etravirine Midazolam 524 | Green: Administer standard doses | Administer standard doses | decreased levels of midazolam |
Midozolam AUC decreased 31%; active metabolite Cmax increased 57% |
Monitor for theraputive effectiveness of midazolam |
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| Efavirenz Midazolam 503 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: weigh risks and benefits of using this combination | Increased midazolam effects (eg, increased sedation, confusion, respiratory depression) |
Not studied |
Not studied (may increase midazolam levels) |
Parenteral midazolam can be used with caution when given as a single dose in a monitored situation for procedural sedation. Chronic midazolam administration (oral or intravenous) should be avoided. |
|
| Cabotegravir Midazolam 331 | Green: Administer standard doses | Administer standard doses | Not studied |
3mg | Cmax increased 9%, AUC increased 10% |
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| Raltegravir Midazolam 302 | Green: Administer standard doses | Administer standard doses | 2 mg x 1 | No significant change |
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| Elvitegravir Midazolam 195 | Red: Avoid combination | Do not coadminister: Potential for increased levels of midazolam | Potential for increased midazolam effects (e.g. prolonged sedation, altered mental status, respiratory depression) |
Co-administration of oral midazolam is contraindicated. Parenteral midazolam can be used with caution when given as a single dose in a closely monitored situation for procedural sedation. |
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| Dolutegravir Midazolam 103 | Green: Administer standard doses | Administer standard doses | Not studied |
3 mg | No significant change |
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| Bictegravir Midazolam 67 | Green: Administer standard doses | Administer standard doses | Potential for increased sedation |
Not reported |
2 mg single dose | Cmax increased 3%, AUC increased 15% |
