Drug interactions
Crofelemer + Midazolam
Severity: Minor
Crofelemer and Midazolam: minor 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
Crofelemer may inhibit CYP3A4 locally in the gut at concentrations reached in the intestinal lumen. This could theoretically raise exposure to oral midazolam, but crofelemer is minimally absorbed so systemic inhibition is unlikely.
What this interaction means in plain words
Crofelemer and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Crofelemer belongs to Gastrointestinal Tract; Midazolam belongs to Central Nervous System.
Why it happens
Potential inhibition of intestinal CYP3A4 by crofelemer; systemic effect unlikely due to minimal absorption.
What to do
No routine adjustment is needed; observe for excess sedation if oral midazolam is given with crofelemer. Parenteral midazolam is unlikely to be affected.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Crofelemer
- Crofelemer + Ergotamine Moderate
- Alfuzosin + Crofelemer Minor
- Amiodarone + Crofelemer Minor
- Apixaban + Crofelemer Minor
- Aprepitant + Crofelemer Minor
- Armodafinil + Crofelemer Minor
Frequently asked questions
Can I take Crofelemer with Midazolam?
MediHelp rates the interaction as minor. Crofelemer and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Crofelemer may inhibit CYP3A4 locally in the gut at concentrations reached in the intestinal lumen. This could theoretically raise exposure to oral midazolam, but crofelemer is minimally absorbed so systemic inhibition is unlikely.
How serious is the interaction between Crofelemer and Midazolam?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine adjustment is needed; observe for excess sedation if oral midazolam is given with crofelemer. Parenteral midazolam is unlikely to be affected.
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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