Drug interactions
Aprepitant + Midazolam intranasal
Severity: Major
Aprepitant and Midazolam intranasal: major interaction.
Last updated Sources: US FDA label
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
Aprepitant raises midazolam exposure by inhibiting CYP3A4. This may deepen and prolong sedation and risk respiratory depression.
What this interaction means in plain words
Aprepitant and Midazolam intranasal 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.
Why it happens
Aprepitant inhibits CYP3A4, decreasing midazolam metabolism.
What to do
Avoid if possible; otherwise monitor sedation and respiration for a prolonged period and consider reducing the midazolam dose. Ensure resuscitation capability.
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 Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Frequently asked questions
Can I take Aprepitant with Midazolam intranasal?
MediHelp rates the interaction as major. Aprepitant and Midazolam intranasal 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. Aprepitant raises midazolam exposure by inhibiting CYP3A4. This may deepen and prolong sedation and risk respiratory depression.
How serious is the interaction between Aprepitant and Midazolam intranasal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; otherwise monitor sedation and respiration for a prolonged period and consider reducing the midazolam dose. Ensure resuscitation capability.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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