Drug interactions
Cholic acid + Midazolam
Severity: Moderate
Cholic acid 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
Midazolam is listed among drugs that may inhibit the bile salt export pump, which could impair bile acid elimination. This may lead to accumulation of bile salts and liver injury, although the evidence is limited.
What this interaction means in plain words
Cholic acid 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.
Cholic acid belongs to Gastrointestinal Tract; Midazolam belongs to Central Nervous System.
Why it happens
Possible inhibition of the bile salt export pump (BSEP), reducing hepatic bile acid efflux.
What to do
Monitor serum transaminases and bilirubin if both are used together, and stop cholic acid if liver tests worsen.
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
Other interactions of Cholic acid
Frequently asked questions
Can I take Cholic acid with Midazolam?
MediHelp rates the interaction as moderate. Cholic acid 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. Midazolam is listed among drugs that may inhibit the bile salt export pump, which could impair bile acid elimination. This may lead to accumulation of bile salts and liver injury, although the evidence is limited.
How serious is the interaction between Cholic acid 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 serum transaminases and bilirubin if both are used together, and stop cholic acid if liver tests worsen.
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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