Drug interactions
Belladonna and opium + Midazolam
Severity: Major
Belladonna and opium and Midazolam: major 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
The opium component is an opioid, and combining it with midazolam causes additive sedation, respiratory depression, hypotension and potentially coma or death. Belladonna alkaloids may add anticholinergic confusion.
What this interaction means in plain words
Belladonna and opium 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.
Why it happens
Synergistic CNS and respiratory depression from opioid receptor agonism and GABA-A potentiation.
What to do
Avoid if possible; otherwise use the lowest doses for the shortest time and monitor respiratory rate and sedation closely. Consider naloxone availability.
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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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 Belladonna and opium with Midazolam?
MediHelp rates the interaction as major. Belladonna and opium 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. The opium component is an opioid, and combining it with midazolam causes additive sedation, respiratory depression, hypotension and potentially coma or death. Belladonna alkaloids may add anticholinergic confusion.
How serious is the interaction between Belladonna and opium 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: Avoid if possible; otherwise use the lowest doses for the shortest time and monitor respiratory rate and sedation closely. Consider naloxone availability.
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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