Drug interactions
Hydroxyzine + Midazolam
Severity: Moderate
Hydroxyzine 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
Both agents are sedating and combined use increases drowsiness and psychomotor impairment. Respiratory depression is possible at higher doses.
What this interaction means in plain words
Hydroxyzine 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.
Hydroxyzine belongs to Respiratory; Midazolam belongs to Central Nervous System.
Why it happens
Additive CNS depression from GABA-A potentiation and H1 antagonism.
What to do
Reduce midazolam dose and titrate to effect. Monitor sedation and respiration, and counsel on avoiding driving.
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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Hydroxyzine with Midazolam?
MediHelp rates the interaction as moderate. Hydroxyzine 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. Both agents are sedating and combined use increases drowsiness and psychomotor impairment. Respiratory depression is possible at higher doses.
How serious is the interaction between Hydroxyzine 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 midazolam dose and titrate to effect. Monitor sedation and respiration, and counsel on avoiding driving.
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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