Drug interactions
Elranatamab + Midazolam
Severity: Moderate
Elranatamab 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
Elranatamab can cause cytokine release syndrome, which transiently suppresses CYP enzyme activity. This may increase midazolam exposure and prolong or deepen sedation, especially around step-up dosing.
What this interaction means in plain words
Elranatamab 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.
Elranatamab belongs to Oncology; Midazolam belongs to Central Nervous System.
Why it happens
Cytokine-mediated suppression of CYP3A4 activity during cytokine release syndrome.
What to do
Monitor for excessive sedation and consider a lower midazolam dose during step-up dosing and any CRS episode, up to about two weeks after the first treatment dose.
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 Midazolam
- Atazanavir + Midazolam Contraindicated
- Cobicistat + Midazolam Contraindicated
- Darunavir + Midazolam Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Midazolam Contraindicated
- Fosamprenavir + Midazolam Contraindicated
- Indinavir + Midazolam Contraindicated
Other interactions of Elranatamab
- Elranatamab + Ergotamine Major
- Elranatamab + Pimozide Major
- Bendamustine + Elranatamab Moderate
- Carbamazepine + Elranatamab Moderate
- Clomipramine + Elranatamab Moderate
- Clozapine + Elranatamab Moderate
Frequently asked questions
Can I take Elranatamab with Midazolam?
MediHelp rates the interaction as moderate. Elranatamab 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. Elranatamab can cause cytokine release syndrome, which transiently suppresses CYP enzyme activity. This may increase midazolam exposure and prolong or deepen sedation, especially around step-up dosing.
How serious is the interaction between Elranatamab 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: Monitor for excessive sedation and consider a lower midazolam dose during step-up dosing and any CRS episode, up to about two weeks after the first treatment dose.
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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