Drug interactions
Clemastine + Midazolam intranasal
Severity: Major
Clemastine and Midazolam intranasal: major interaction.
Last updated Sources: US FDA label
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
Both drugs cause sedation, and combining them can increase the risk of hypoventilation, airway obstruction and apnea. Clemastine is a possible weak CYP3A inhibitor and could modestly raise midazolam exposure.
What this interaction means in plain words
Clemastine and Midazolam intranasal 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, with possible weak CYP3A4 inhibition adding to midazolam exposure.
What to do
Monitor respiratory rate, oxygen saturation and level of sedation after dosing, and avoid additional sedatives. Reduce the midazolam dose if prolonged sedation is a concern.
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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References
Other interactions of Clemastine
Frequently asked questions
Can I take Clemastine with Midazolam intranasal?
MediHelp rates the interaction as major. Clemastine and Midazolam intranasal 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. Both drugs cause sedation, and combining them can increase the risk of hypoventilation, airway obstruction and apnea. Clemastine is a possible weak CYP3A inhibitor and could modestly raise midazolam exposure.
How serious is the interaction between Clemastine and Midazolam intranasal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor respiratory rate, oxygen saturation and level of sedation after dosing, and avoid additional sedatives. Reduce the midazolam dose if prolonged sedation is a concern.
What other medicines interact with Clemastine?
MediHelp also lists interactions of Clemastine with, for example, Alfentanil, Benzhydrocodone / acetaminophen, Buprenorphine buccal. The full list is on the Clemastine page.
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