Drug interactions
Gabapentin + Midazolam
Severity: Major
Gabapentin and Midazolam: major 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
Gabapentin combined with midazolam increases sedation and the risk of respiratory depression. This is most concerning in older patients, those with lung disease, and during procedural sedation.
What this interaction means in plain words
Gabapentin 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.
Gabapentin belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression via GABAergic enhancement (midazolam) and alpha-2-delta calcium channel modulation (gabapentin).
What to do
Use the lowest effective doses, titrate midazolam slowly, and monitor sedation level, respiratory rate and oxygen saturation.
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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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 Gabapentin
Frequently asked questions
Can I take Gabapentin with Midazolam?
MediHelp rates the interaction as major. Gabapentin 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. Gabapentin combined with midazolam increases sedation and the risk of respiratory depression. This is most concerning in older patients, those with lung disease, and during procedural sedation.
How serious is the interaction between Gabapentin 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: Use the lowest effective doses, titrate midazolam slowly, and monitor sedation level, respiratory rate and oxygen saturation.
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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