Drug interactions
Ethanol + Midazolam
Severity: Major
Ethanol 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
Alcohol potentiates the sedative and respiratory depressant effects of midazolam. Impaired alertness, coordination and breathing may occur, especially at higher doses or in vulnerable patients.
What this interaction means in plain words
Ethanol 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 CNS depression through GABA-A potentiation by both agents.
What to do
Advise patients to avoid alcohol before and after midazolam, and for procedural sedation ask about recent alcohol intake and monitor oxygenation and ventilation closely.
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 Ethanol with Midazolam?
MediHelp rates the interaction as major. Ethanol 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. Alcohol potentiates the sedative and respiratory depressant effects of midazolam. Impaired alertness, coordination and breathing may occur, especially at higher doses or in vulnerable patients.
How serious is the interaction between Ethanol 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: Advise patients to avoid alcohol before and after midazolam, and for procedural sedation ask about recent alcohol intake and monitor oxygenation and ventilation closely.
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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