Drug interactions
Ciprofloxacin + Midazolam
Severity: Moderate
Ciprofloxacin 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
Ciprofloxacin is a weak to moderate CYP3A4 inhibitor and can modestly raise midazolam exposure. This may deepen or prolong sedation and respiratory depression, especially with repeated dosing or in frail patients.
What this interaction means in plain words
Ciprofloxacin 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.
Ciprofloxacin belongs to Anti Bacterial; Midazolam belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated metabolism of midazolam reduces its clearance.
What to do
Use the lowest effective midazolam dose and monitor sedation level and respiratory status for longer than usual. Reduce the dose or lengthen the interval between doses if excessive sedation occurs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ciprofloxacin and Midazolam, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Ciprofloxacin
- Agomelatine + Ciprofloxacin Contraindicated
- Ciprofloxacin + Fezolinetant Contraindicated
- Ciprofloxacin + Thioridazine Contraindicated
- Ciprofloxacin + Tizanidine Contraindicated
- Ciprofloxacin + Vandetanib Contraindicated
- Alosetron + Ciprofloxacin Major
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 Ciprofloxacin with Midazolam?
MediHelp rates the interaction as moderate. Ciprofloxacin 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. Ciprofloxacin is a weak to moderate CYP3A4 inhibitor and can modestly raise midazolam exposure. This may deepen or prolong sedation and respiratory depression, especially with repeated dosing or in frail patients.
How serious is the interaction between Ciprofloxacin 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: Use the lowest effective midazolam dose and monitor sedation level and respiratory status for longer than usual. Reduce the dose or lengthen the interval between doses if excessive sedation occurs.
What other medicines interact with Ciprofloxacin?
MediHelp also lists interactions of Ciprofloxacin with, for example, Agomelatine, Fezolinetant, Thioridazine. The full list is on the Ciprofloxacin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
