Drug interactions
Carbamazepine + Midazolam intranasal
Severity: Moderate
Carbamazepine and Midazolam intranasal: 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
Carbamazepine is a potent CYP3A4 inducer and substantially lowers midazolam exposure, which may cause seizure rescue treatment to fail. Carbamazepine also has additive CNS depressant effects with midazolam, with risk of sedation and respiratory depression.
What this interaction means in plain words
Carbamazepine and Midazolam intranasal 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
Carbamazepine induces CYP3A4-mediated midazolam metabolism, and both drugs have additive CNS depressant effects.
What to do
Monitor the response to intranasal midazolam and be prepared to give additional or alternative rescue therapy. Observe respiratory status and sedation after dosing.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Midazolam intranasal?
MediHelp rates the interaction as moderate. Carbamazepine and Midazolam intranasal 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. Carbamazepine is a potent CYP3A4 inducer and substantially lowers midazolam exposure, which may cause seizure rescue treatment to fail. Carbamazepine also has additive CNS depressant effects with midazolam, with risk of sedation and respiratory depression.
How serious is the interaction between Carbamazepine and Midazolam intranasal?
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 the response to intranasal midazolam and be prepared to give additional or alternative rescue therapy. Observe respiratory status and sedation after dosing.
What other medicines interact with Carbamazepine?
MediHelp also lists interactions of Carbamazepine with, for example, Artemether / lumefantrine, Cabotegravir, Delamanid. The full list is on the Carbamazepine page.
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