Drug interactions
Azelastine + Midazolam intranasal
Severity: Moderate
Azelastine and Midazolam intranasal: 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
Midazolam is cleared by CYP3A4, and inhibitors can raise exposure and prolong sedation. Azelastine adds its own sedative effect and may weakly inhibit CYP3A4.
What this interaction means in plain words
Azelastine and Midazolam intranasal 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
Additive CNS depression plus possible weak CYP3A4 inhibition.
What to do
Monitor sedation and respiratory function for a longer period after midazolam dosing. Avoid additional sedatives and driving.
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 Azelastine
Frequently asked questions
Can I take Azelastine with Midazolam intranasal?
MediHelp rates the interaction as moderate. Azelastine and Midazolam intranasal 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. Midazolam is cleared by CYP3A4, and inhibitors can raise exposure and prolong sedation. Azelastine adds its own sedative effect and may weakly inhibit CYP3A4.
How serious is the interaction between Azelastine and Midazolam intranasal?
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 sedation and respiratory function for a longer period after midazolam dosing. Avoid additional sedatives and driving.
What other medicines interact with Azelastine?
MediHelp also lists interactions of Azelastine with, for example, Calcium / magnesium / potassium / sodium oxybates, Methadone, Sodium oxybate. The full list is on the Azelastine page.
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