Drug interactions
Azelastine + Midazolam
Severity: Moderate
Azelastine 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
Azelastine can add to the sedative and respiratory depressant effects of midazolam. This is clinically relevant during procedural sedation or when midazolam is given with other depressants.
What this interaction means in plain words
Azelastine 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.
Azelastine belongs to Respiratory; Midazolam belongs to Central Nervous System.
Why it happens
Additive CNS depression through H1-receptor antagonism and GABA-A potentiation.
What to do
Titrate midazolam carefully and monitor oxygen saturation and level of sedation. Consider a lower dose when azelastine is being used systemically.
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
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 Azelastine with Midazolam?
MediHelp rates the interaction as moderate. Azelastine 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. Azelastine can add to the sedative and respiratory depressant effects of midazolam. This is clinically relevant during procedural sedation or when midazolam is given with other depressants.
How serious is the interaction between Azelastine 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: Titrate midazolam carefully and monitor oxygen saturation and level of sedation. Consider a lower dose when azelastine is being used systemically.
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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