Drug interactions
Idelalisib + Midazolam
Severity: Major
Idelalisib 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
Idelalisib is a strong CYP3A4 inhibitor and substantially increases midazolam exposure, with prolonged sedation and respiratory depression. The risk is greatest with oral or repeated midazolam dosing.
What this interaction means in plain words
Idelalisib 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.
Idelalisib belongs to Oncology; Midazolam belongs to Central Nervous System.
Why it happens
Idelalisib strongly inhibits CYP3A4, reducing midazolam first-pass and systemic clearance.
What to do
Avoid oral midazolam; for single IV doses, reduce the dose and monitor sedation and respiration for longer. Use a non-CYP3A4 benzodiazepine for chronic therapy.
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 Idelalisib
- Alfuzosin + Idelalisib Contraindicated
- Cisapride + Idelalisib Contraindicated
- Dihydroergotamine + Idelalisib Contraindicated
- Dronedarone + Idelalisib Contraindicated
- Eletriptan + Idelalisib Contraindicated
- Eplerenone + Idelalisib Contraindicated
Frequently asked questions
Can I take Idelalisib with Midazolam?
MediHelp rates the interaction as major. Idelalisib 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. Idelalisib is a strong CYP3A4 inhibitor and substantially increases midazolam exposure, with prolonged sedation and respiratory depression. The risk is greatest with oral or repeated midazolam dosing.
How serious is the interaction between Idelalisib 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: Avoid oral midazolam; for single IV doses, reduce the dose and monitor sedation and respiration for longer. Use a non-CYP3A4 benzodiazepine for chronic therapy.
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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