Drug interactions
Clorazepate + Midazolam
Severity: Moderate
Clorazepate 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
Both are benzodiazepines, and combining them produces additive CNS and respiratory depression. This is most relevant when midazolam is given for procedural sedation to a patient who takes clorazepate regularly. Excess sedation, hypoventilation and delayed recovery can occur.
What this interaction means in plain words
Clorazepate 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.
Clorazepate belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Additive GABA-A receptor positive allosteric modulation, causing pharmacodynamic CNS and respiratory depression.
What to do
Titrate midazolam slowly to effect, using reduced doses in patients on chronic clorazepate. Monitor respiratory rate and oxygen saturation continuously during and after sedation.
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 Clorazepate
- Calcium / magnesium / potassium / sodium oxybates + Clorazepate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
- Alfentanil + Clorazepate Major
- Alprazolam + Clorazepate Major
- Amobarbital + Clorazepate Major
- Belladonna and opium + Clorazepate 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 Clorazepate with Midazolam?
MediHelp rates the interaction as moderate. Clorazepate 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. Both are benzodiazepines, and combining them produces additive CNS and respiratory depression. This is most relevant when midazolam is given for procedural sedation to a patient who takes clorazepate regularly. Excess sedation, hypoventilation and delayed recovery can occur.
How serious is the interaction between Clorazepate 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: Titrate midazolam slowly to effect, using reduced doses in patients on chronic clorazepate. Monitor respiratory rate and oxygen saturation continuously during and after sedation.
What other medicines interact with Clorazepate?
MediHelp also lists interactions of Clorazepate with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Clorazepate page.
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