Drug interactions
Guanfacine + Midazolam
Severity: Moderate
Guanfacine 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
Guanfacine commonly causes somnolence, hypotension and bradycardia, which may add to the sedation of midazolam. The combination can increase drowsiness and dizziness.
What this interaction means in plain words
Guanfacine 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.
Guanfacine belongs to Cardiovascular; Midazolam belongs to Central Nervous System.
Why it happens
Additive CNS depression from alpha-2 agonism and GABA-A potentiation.
What to do
Use lower midazolam doses and monitor sedation, blood pressure and heart rate. Advise patients to avoid driving or hazardous tasks.
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 Guanfacine
- Clonidine + Guanfacine Major
- Guanfacine + Lofexidine Major
- Aldesleukin + Guanfacine Moderate
- Amiodarone + Guanfacine Moderate
- Amisulpride + Guanfacine Moderate
- Amitriptyline + Guanfacine Moderate
Frequently asked questions
Can I take Guanfacine with Midazolam?
MediHelp rates the interaction as moderate. Guanfacine 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. Guanfacine commonly causes somnolence, hypotension and bradycardia, which may add to the sedation of midazolam. The combination can increase drowsiness and dizziness.
How serious is the interaction between Guanfacine 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: Use lower midazolam doses and monitor sedation, blood pressure and heart rate. Advise patients to avoid driving or hazardous tasks.
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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