Drug interactions
Istradefylline + Midazolam
Severity: Moderate
Istradefylline 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
At higher doses, istradefylline increases exposure to CYP3A4 substrates such as midazolam, which may lengthen or intensify sedation. This effect was not seen at the lower dose.
What this interaction means in plain words
Istradefylline 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.
Istradefylline belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Dose-dependent inhibition of CYP3A4 by istradefylline.
What to do
If istradefylline 40 mg daily is used, consider lowering the midazolam dose and monitor sedation.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Istradefylline and Midazolam, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Istradefylline
Frequently asked questions
Can I take Istradefylline with Midazolam?
MediHelp rates the interaction as moderate. Istradefylline 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. At higher doses, istradefylline increases exposure to CYP3A4 substrates such as midazolam, which may lengthen or intensify sedation. This effect was not seen at the lower dose.
How serious is the interaction between Istradefylline 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: If istradefylline 40 mg daily is used, consider lowering the midazolam dose and monitor sedation.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
