Drug interactions
Efavirenz + Midazolam intranasal
Severity: Moderate
Efavirenz and Midazolam intranasal: 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
Efavirenz affects midazolam in a complex way, and CYP3A4 induction may reduce exposure over time. Both agents also have CNS effects, so additive sedation is possible. Intranasal midazolam is given as a single rescue dose, so any pharmacokinetic effect is uncertain.
What this interaction means in plain words
Efavirenz and Midazolam intranasal 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.
Why it happens
Additive CNS depression, with possible alteration of CYP3A4-mediated midazolam metabolism by efavirenz.
What to do
Monitor respiratory status and sedation after dosing and have resuscitation capability available. Adjust further doses according to clinical response.
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 Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Efavirenz with Midazolam intranasal?
MediHelp rates the interaction as moderate. Efavirenz and Midazolam intranasal 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. Efavirenz affects midazolam in a complex way, and CYP3A4 induction may reduce exposure over time. Both agents also have CNS effects, so additive sedation is possible. Intranasal midazolam is given as a single rescue dose, so any pharmacokinetic effect is uncertain.
How serious is the interaction between Efavirenz and Midazolam intranasal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor respiratory status and sedation after dosing and have resuscitation capability available. Adjust further doses according to clinical response.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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