Drug interactions
Cyproheptadine + Midazolam
Severity: Moderate
Cyproheptadine 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
A sedating antihistamine given with midazolam can deepen sedation and increase the risk of respiratory depression, particularly with parenteral midazolam or in frail patients.
What this interaction means in plain words
Cyproheptadine 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.
Cyproheptadine belongs to Respiratory; Midazolam belongs to Central Nervous System.
Why it happens
Additive CNS depression via H1 antagonism and GABA-A receptor potentiation.
What to do
Titrate midazolam cautiously and monitor level of consciousness, respiratory rate and oxygen saturation. Use a lower midazolam dose when the combination is needed.
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 Cyproheptadine
- Cyproheptadine + Isocarboxazid Contraindicated
- Cyproheptadine + Phenelzine Contraindicated
- Cyproheptadine + Tranylcypromine Contraindicated
- Alfentanil + Cyproheptadine Major
- Belladonna and opium + Cyproheptadine Major
- Benzhydrocodone / acetaminophen + Cyproheptadine 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 Cyproheptadine with Midazolam?
MediHelp rates the interaction as moderate. Cyproheptadine 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. A sedating antihistamine given with midazolam can deepen sedation and increase the risk of respiratory depression, particularly with parenteral midazolam or in frail patients.
How serious is the interaction between Cyproheptadine 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 cautiously and monitor level of consciousness, respiratory rate and oxygen saturation. Use a lower midazolam dose when the combination is needed.
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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