Drug interactions
Fluoxetine + Midazolam
Severity: Moderate
Fluoxetine 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
Fluoxetine and its metabolite norfluoxetine weakly inhibit CYP3A4, which may modestly raise midazolam exposure. Additive CNS effects such as drowsiness and psychomotor impairment may also occur.
What this interaction means in plain words
Fluoxetine 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.
Fluoxetine belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Weak CYP3A4 inhibition by norfluoxetine plus additive CNS effects.
What to do
Titrate midazolam slowly and monitor sedation and recovery time. Counsel patients to avoid driving after dosing.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Midazolam?
MediHelp rates the interaction as moderate. Fluoxetine 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. Fluoxetine and its metabolite norfluoxetine weakly inhibit CYP3A4, which may modestly raise midazolam exposure. Additive CNS effects such as drowsiness and psychomotor impairment may also occur.
How serious is the interaction between Fluoxetine 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 slowly and monitor sedation and recovery time. Counsel patients to avoid driving after dosing.
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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