Drug interactions
Cyproheptadine + Midazolam intranasal
Severity: Major
Cyproheptadine 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
Midazolam depresses respiration and consciousness, and a sedating antihistamine such as cyproheptadine can deepen and prolong this effect. Risks include hypoventilation, airway obstruction and oxygen desaturation.
What this interaction means in plain words
Cyproheptadine 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 via GABA-A potentiation and H1 antagonism.
What to do
Monitor respiratory rate, oxygen saturation and level of consciousness after dosing, with resuscitation equipment available. Avoid cyproheptadine around midazolam use where possible, or reduce the dose.
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 Cyproheptadine
- Cyproheptadine + Isocarboxazid Contraindicated
- Cyproheptadine + Phenelzine Contraindicated
- Cyproheptadine + Tranylcypromine Contraindicated
- Alfentanil + Cyproheptadine Major
- Belladonna and opium + Cyproheptadine Major
- Benzhydrocodone / acetaminophen + Cyproheptadine Major
Frequently asked questions
Can I take Cyproheptadine with Midazolam intranasal?
MediHelp rates the interaction as major. Cyproheptadine 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. Midazolam depresses respiration and consciousness, and a sedating antihistamine such as cyproheptadine can deepen and prolong this effect. Risks include hypoventilation, airway obstruction and oxygen desaturation.
How serious is the interaction between Cyproheptadine 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 consciousness after dosing, with resuscitation equipment available. Avoid cyproheptadine around midazolam use where possible, or reduce the dose.
What other medicines interact with Cyproheptadine?
MediHelp also lists interactions of Cyproheptadine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Cyproheptadine page.
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