Drug interactions
Ethinyl estradiol-levonorgestrel + Midazolam
Severity: Moderate
Ethinyl estradiol-levonorgestrel 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
Ethinyl estradiol can reduce the oxidative clearance of midazolam, leading to higher exposure and prolonged sedation. The effect is typically modest but may be relevant with repeated dosing or in sedation procedures.
What this interaction means in plain words
Ethinyl estradiol-levonorgestrel 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.
Ethinyl estradiol-levonorgestrel belongs to Endocrine; Midazolam belongs to Central Nervous System.
Why it happens
Weak inhibition of CYP3A4-mediated metabolism of midazolam by ethinyl estradiol.
What to do
Titrate midazolam to clinical effect and monitor sedation and respiratory status; a lower dose may be needed.
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 Ethinyl estradiol-levonorgestrel
- Ethinyl estradiol-levonorgestrel + Fezolinetant Contraindicated
- Ethinyl estradiol-levonorgestrel + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-levonorgestrel + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-levonorgestrel Major
- Amobarbital + Ethinyl estradiol-levonorgestrel Major
- Anastrozole + Ethinyl estradiol-levonorgestrel 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 Ethinyl estradiol-levonorgestrel with Midazolam?
MediHelp rates the interaction as moderate. Ethinyl estradiol-levonorgestrel 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. Ethinyl estradiol can reduce the oxidative clearance of midazolam, leading to higher exposure and prolonged sedation. The effect is typically modest but may be relevant with repeated dosing or in sedation procedures.
How serious is the interaction between Ethinyl estradiol-levonorgestrel 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: Titrate midazolam to clinical effect and monitor sedation and respiratory status; a lower dose may be needed.
What other medicines interact with Ethinyl estradiol-levonorgestrel?
MediHelp also lists interactions of Ethinyl estradiol-levonorgestrel with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-levonorgestrel page.
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