Drug interactions
Diazepam + Midazolam
Severity: Major
Diazepam 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
Combining two benzodiazepines increases sedation, amnesia and the risk of respiratory depression. This is most important during procedural sedation or in patients with respiratory compromise.
What this interaction means in plain words
Diazepam 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.
Diazepam belongs to Musculoskeletal; Midazolam belongs to Central Nervous System.
Why it happens
Additive GABA-A receptor mediated CNS and respiratory depression.
What to do
Avoid duplicate benzodiazepine therapy when possible. If both are required, reduce doses, titrate carefully and monitor oxygen saturation and level of consciousness.
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 Diazepam
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 Diazepam with Midazolam?
MediHelp rates the interaction as major. Diazepam 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. Combining two benzodiazepines increases sedation, amnesia and the risk of respiratory depression. This is most important during procedural sedation or in patients with respiratory compromise.
How serious is the interaction between Diazepam 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: Avoid duplicate benzodiazepine therapy when possible. If both are required, reduce doses, titrate carefully and monitor oxygen saturation and level of consciousness.
What other medicines interact with Diazepam?
MediHelp also lists interactions of Diazepam with, for example, Calcium / magnesium / potassium / sodium oxybates, Alfentanil, Alprazolam. The full list is on the Diazepam page.
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