Drug interactions
Diazepam intranasal + Midazolam
Severity: Major
Diazepam intranasal 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
Two benzodiazepines given together produce additive CNS depression, with excessive sedation and potential respiratory depression. This is relevant when rescue seizure therapy is given alongside midazolam.
What this interaction means in plain words
Diazepam intranasal 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.
Why it happens
Additive positive allosteric modulation of GABA-A receptors.
What to do
Avoid giving both unless clinically necessary, and allow adequate time between doses. Monitor respiratory rate, oxygen saturation and consciousness, with airway support available.
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 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 intranasal with Midazolam?
MediHelp rates the interaction as major. Diazepam intranasal 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. Two benzodiazepines given together produce additive CNS depression, with excessive sedation and potential respiratory depression. This is relevant when rescue seizure therapy is given alongside midazolam.
How serious is the interaction between Diazepam intranasal 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 giving both unless clinically necessary, and allow adequate time between doses. Monitor respiratory rate, oxygen saturation and consciousness, with airway support available.
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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