Drug interactions
Artemether / lumefantrine + Midazolam
Severity: Moderate
Artemether / lumefantrine and Midazolam: moderate interaction.
Last updated
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
Artemether can induce CYP3A4, which may lower midazolam concentrations and reduce its effect. Lumefantrine and artemether are themselves CYP3A4 substrates, and the net effect varies.
What this interaction means in plain words
Artemether / lumefantrine and Midazolam can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Induction of CYP3A4 by artemether increases midazolam metabolism.
What to do
Monitor for reduced sedative or anxiolytic effect and titrate midazolam to response. Account for the possible effect on oral midazolam in particular.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Frequently asked questions
Can I take Artemether / lumefantrine with Midazolam?
MediHelp rates the interaction as moderate. Artemether / lumefantrine and Midazolam can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Artemether can induce CYP3A4, which may lower midazolam concentrations and reduce its effect. Lumefantrine and artemether are themselves CYP3A4 substrates, and the net effect varies.
How serious is the interaction between Artemether / lumefantrine and Midazolam?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced sedative or anxiolytic effect and titrate midazolam to response. Account for the possible effect on oral midazolam in particular.
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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