Drug interactions
Clobazam + Midazolam
Severity: Major
Clobazam and Midazolam: 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
Clobazam is a benzodiazepine, so combining it with midazolam produces additive CNS and respiratory depression. Clobazam is also a weak CYP3A4 inducer rather than an inhibitor, so the main concern is pharmacodynamic.
What this interaction means in plain words
Clobazam 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.
Clobazam belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Additive GABA-A mediated CNS and respiratory depression from two benzodiazepines.
What to do
Reduce the midazolam dose and titrate slowly, with continuous monitoring of respiratory rate and oxygen saturation; ensure airway support and reversal agents are available.
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 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 Clobazam
- Amobarbital + Clobazam Major
- Buprenorphine + Clobazam Major
- Butorphanol + Clobazam Major
- Carisoprodol + Clobazam Major
- Chloral hydrate + Clobazam Major
- Clobazam + Clozapine Major
Frequently asked questions
Can I take Clobazam with Midazolam?
MediHelp rates the interaction as major. Clobazam 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. Clobazam is a benzodiazepine, so combining it with midazolam produces additive CNS and respiratory depression. Clobazam is also a weak CYP3A4 inducer rather than an inhibitor, so the main concern is pharmacodynamic.
How serious is the interaction between Clobazam 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: Reduce the midazolam dose and titrate slowly, with continuous monitoring of respiratory rate and oxygen saturation; ensure airway support and reversal agents are available.
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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