Drug interactions
Fluvoxamine + Midazolam
Severity: Moderate
Fluvoxamine 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
Fluvoxamine can raise midazolam exposure and prolong its effects, with greater sedation and a higher risk of respiratory depression. The effect is more important with oral midazolam.
What this interaction means in plain words
Fluvoxamine 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.
Fluvoxamine belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 (and other CYPs) by fluvoxamine reduces midazolam clearance, adding to pharmacodynamic CNS depression.
What to do
Reduce the midazolam dose and monitor sedation and respiratory function, particularly after oral dosing or repeated use. Consider an alternative benzodiazepine not dependent on CYP3A4, such as lorazepam.
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 Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue Contraindicated
Frequently asked questions
Can I take Fluvoxamine with Midazolam?
MediHelp rates the interaction as moderate. Fluvoxamine 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. Fluvoxamine can raise midazolam exposure and prolong its effects, with greater sedation and a higher risk of respiratory depression. The effect is more important with oral midazolam.
How serious is the interaction between Fluvoxamine 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: Reduce the midazolam dose and monitor sedation and respiratory function, particularly after oral dosing or repeated use. Consider an alternative benzodiazepine not dependent on CYP3A4, such as lorazepam.
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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