Drug interactions
Isoflurane + Midazolam intranasal
Severity: Major
Isoflurane and Midazolam intranasal: major interaction.
Last updated Sources: UK SmPC
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
Midazolam and isoflurane both depress the CNS and respiration, so together they can cause deeper sedation, hypoventilation and apnea. The anesthetic requirement is usually reduced.
What this interaction means in plain words
Isoflurane and Midazolam intranasal 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.
Why it happens
Additive GABA-A mediated CNS and respiratory depression.
What to do
Reduce the anesthetic dose and titrate to effect. Monitor oxygen saturation and ventilation continuously, with airway support available.
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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References
- AErrane 100% Liquid Inhalation Vapour - SmPC sections 4.3/4.5 (class statement: benzodiazepines; "Opioids, benzodiazepines and other sedative agents are associated with respiratory depression, and caution should be exercised when concomitantly administered w") — electronic medicines compendium (UK SmPC)
Other interactions of Isoflurane
Frequently asked questions
Can I take Isoflurane with Midazolam intranasal?
MediHelp rates the interaction as major. Isoflurane and Midazolam intranasal 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. Midazolam and isoflurane both depress the CNS and respiration, so together they can cause deeper sedation, hypoventilation and apnea. The anesthetic requirement is usually reduced.
How serious is the interaction between Isoflurane and Midazolam intranasal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the anesthetic dose and titrate to effect. Monitor oxygen saturation and ventilation continuously, with airway support available.
What other medicines interact with Isoflurane?
MediHelp also lists interactions of Isoflurane with, for example, Adrenaline-articaine, Amisulpride, Arsenic trioxide. The full list is on the Isoflurane page.
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