Drug interactions
Calcium / magnesium / potassium / sodium oxybates + Midazolam
Severity: Major
Calcium / magnesium / potassium / sodium oxybates 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
Oxybates are potent CNS depressants, and combining them with midazolam can cause profound sedation, respiratory depression, coma and death. Oxybate labeling advises against concomitant use with sedative hypnotics.
What this interaction means in plain words
Calcium / magnesium / potassium / sodium oxybates 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
Additive CNS and respiratory depression through GABA-B/GHB receptor activity of oxybate and GABA-A potentiation by midazolam.
What to do
Avoid the combination where possible; if midazolam is required, use the lowest dose and monitor respiration and consciousness closely. Consider interrupting oxybate dosing around procedures.
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 Calcium / magnesium / potassium / sodium oxybates with Midazolam?
MediHelp rates the interaction as major. Calcium / magnesium / potassium / sodium oxybates 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. Oxybates are potent CNS depressants, and combining them with midazolam can cause profound sedation, respiratory depression, coma and death. Oxybate labeling advises against concomitant use with sedative hypnotics.
How serious is the interaction between Calcium / magnesium / potassium / sodium oxybates 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 the combination where possible; if midazolam is required, use the lowest dose and monitor respiration and consciousness closely. Consider interrupting oxybate dosing around procedures.
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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