Drug interactions
Esomeprazole + Midazolam
Severity: Minor
Esomeprazole and Midazolam: minor 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
Esomeprazole does not meaningfully inhibit CYP3A4, the main pathway for midazolam clearance. Any increase in midazolam levels is expected to be negligible.
What this interaction means in plain words
Esomeprazole and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Esomeprazole belongs to Gastrointestinal Tract; Midazolam belongs to Central Nervous System.
Why it happens
Theoretical weak CYP3A4 inhibition; not shown to be clinically relevant.
What to do
No adjustment is needed; titrate midazolam to sedation as usual.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Esomeprazole
- Esomeprazole + Mavacamten Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Esomeprazole Major
- Atazanavir + Esomeprazole Major
- Citalopram + Esomeprazole Major
- Clopidogrel + Esomeprazole 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 Esomeprazole with Midazolam?
MediHelp rates the interaction as minor. Esomeprazole and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Esomeprazole does not meaningfully inhibit CYP3A4, the main pathway for midazolam clearance. Any increase in midazolam levels is expected to be negligible.
How serious is the interaction between Esomeprazole and Midazolam?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No adjustment is needed; titrate midazolam to sedation as usual.
What other medicines interact with Esomeprazole?
MediHelp also lists interactions of Esomeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Esomeprazole page.
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