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Drug interactions

Brexanolone + Midazolam

Severity: Major

Brexanolone and Midazolam: 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

Brexanolone causes excessive sedation and sudden loss of consciousness, and a benzodiazepine may intensify these effects. Both are GABA-A modulators.

What this interaction means in plain words

Brexanolone 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.

Evidence level: Moderate

Why it happens

Additive GABA-A receptor positive modulation causing CNS depression.

What to do

Monitor continuously for sedation and hypoxia during infusion, and reduce or interrupt brexanolone if excessive sedation occurs. Avoid concomitant benzodiazepines where possible.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Brexanolone with Midazolam?

MediHelp rates the interaction as major. Brexanolone 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. Brexanolone causes excessive sedation and sudden loss of consciousness, and a benzodiazepine may intensify these effects. Both are GABA-A modulators.

How serious is the interaction between Brexanolone 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: Monitor continuously for sedation and hypoxia during infusion, and reduce or interrupt brexanolone if excessive sedation occurs. Avoid concomitant benzodiazepines where possible.

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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