Drug interactions
Etravirine + Midazolam
Severity: Moderate
Etravirine 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
Etravirine can lower midazolam concentrations by inducing its metabolism, which may reduce sedative effect. With oral midazolam the effect on first-pass metabolism may be greater than with the intravenous route.
What this interaction means in plain words
Etravirine 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.
Etravirine belongs to Anti Virals; Midazolam belongs to Central Nervous System.
Why it happens
Induction of CYP3A4 by etravirine increases midazolam clearance.
What to do
Monitor clinical response and titrate midazolam to effect, with higher doses possibly needed; be aware that enzyme induction fades after etravirine is stopped.
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 Etravirine
- Efavirenz + Etravirine Contraindicated
- Etravirine + Isavuconazole Contraindicated
- Amobarbital + Etravirine Major
- Apalutamide + Etravirine Major
- Carbamazepine + Etravirine Major
- Cobicistat + Etravirine Major
Frequently asked questions
Can I take Etravirine with Midazolam?
MediHelp rates the interaction as moderate. Etravirine 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. Etravirine can lower midazolam concentrations by inducing its metabolism, which may reduce sedative effect. With oral midazolam the effect on first-pass metabolism may be greater than with the intravenous route.
How serious is the interaction between Etravirine 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 clinical response and titrate midazolam to effect, with higher doses possibly needed; be aware that enzyme induction fades after etravirine is stopped.
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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