Drug interactions
Guselkumab + Midazolam
Severity: Minor
Guselkumab and Midazolam: minor 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
Chronic inflammation suppresses CYP enzyme expression, and effective IL-23 blockade may restore it, potentially lowering levels of CYP3A4 substrates such as midazolam. The effect is theoretical and likely small for midazolam.
What this interaction means in plain words
Guselkumab and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Guselkumab belongs to Miscellaneous; Midazolam belongs to Central Nervous System.
Why it happens
Normalization of cytokine-suppressed CYP3A4 expression after reduction of inflammation.
What to do
No routine dose change is needed; monitor midazolam effect when guselkumab is started or stopped.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Guselkumab
- Adenovirus types 4 and 7 live + Guselkumab Major
- Bcg vaccine live + Guselkumab Major
- Guselkumab + Influenza virus vaccine quadrivalent intranasal Major
- Guselkumab + Measles mumps and rubella vaccine live Major
- Guselkumab + Measles mumps rubella and varicella vaccine live Major
- Guselkumab + Measles vaccine Major
Frequently asked questions
Can I take Guselkumab with Midazolam?
MediHelp rates the interaction as minor. Guselkumab and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Chronic inflammation suppresses CYP enzyme expression, and effective IL-23 blockade may restore it, potentially lowering levels of CYP3A4 substrates such as midazolam. The effect is theoretical and likely small for midazolam.
How serious is the interaction between Guselkumab and Midazolam?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed; monitor midazolam effect when guselkumab is started or 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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