Drug interactions
Amobarbital + Midazolam
Severity: Major
Amobarbital and Midazolam: major interaction.
Last updated Sources: EMA SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amobarbital induces CYP3A4, which can lower midazolam exposure and shorten or weaken its effect. At the same time both drugs are CNS depressants, so additive sedation and respiratory depression can occur, which makes the net effect unpredictable.
What this interaction means in plain words
Amobarbital and Midazolam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amobarbital belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Barbiturate induction of CYP3A4 reduces midazolam levels, combined with additive GABA-A mediated CNS and respiratory depression.
What to do
Titrate midazolam to clinical response with continuous monitoring of sedation, oxygenation and respiration; expect higher dose needs with chronic barbiturate use. Have airway support available.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Midazolam
- Atazanavir + Midazolam Contraindicated
- Cobicistat + Midazolam Contraindicated
- Darunavir + Midazolam Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Midazolam Contraindicated
- Fosamprenavir + Midazolam Contraindicated
- Indinavir + Midazolam Contraindicated
Other interactions of Amobarbital
- Amobarbital + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Amobarbital + Doravirine Contraindicated
- Amobarbital + Elbasvir / grazoprevir Contraindicated
- Amobarbital + Isavuconazonium Contraindicated
- Amobarbital + Isocarboxazid Contraindicated
- Amobarbital + Lonafarnib Contraindicated
Frequently asked questions
Can I take Amobarbital with Midazolam?
MediHelp rates the interaction as major. Amobarbital and Midazolam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Amobarbital induces CYP3A4, which can lower midazolam exposure and shorten or weaken its effect. At the same time both drugs are CNS depressants, so additive sedation and respiratory depression can occur, which makes the net effect unpredictable.
How serious is the interaction between Amobarbital and Midazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate midazolam to clinical response with continuous monitoring of sedation, oxygenation and respiration; expect higher dose needs with chronic barbiturate use. Have airway support available.
What other medicines interact with Midazolam?
MediHelp also lists interactions of Midazolam with, for example, Atazanavir, Cobicistat, Darunavir. The full list is on the Midazolam page.
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