Drug interactions
Butalbital + Midazolam
Severity: Moderate
Butalbital 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
Butalbital is a barbiturate that adds to midazolam sedation and respiratory depression. With chronic use it may induce CYP3A4 and lower midazolam exposure.
What this interaction means in plain words
Butalbital 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
Additive CNS depression plus CYP3A4 induction by butalbital increasing midazolam metabolism.
What to do
Monitor sedation and respiratory status and titrate midazolam to effect. Expect variable dose requirements in patients taking butalbital regularly.
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 Butalbital with Midazolam?
MediHelp rates the interaction as moderate. Butalbital 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. Butalbital is a barbiturate that adds to midazolam sedation and respiratory depression. With chronic use it may induce CYP3A4 and lower midazolam exposure.
How serious is the interaction between Butalbital 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 sedation and respiratory status and titrate midazolam to effect. Expect variable dose requirements in patients taking butalbital regularly.
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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