Drug interactions
Ketamine + Midazolam
Severity: Moderate
Ketamine 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
The combination is used for procedural sedation, with midazolam often reducing ketamine emergence reactions. Together they can still cause deeper sedation and respiratory depression than either alone.
What this interaction means in plain words
Ketamine 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.
Ketamine belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Additive CNS depression from GABA-A potentiation and NMDA antagonism.
What to do
Titrate each drug to effect, using reduced doses. Monitor oxygen saturation, ventilation and level of consciousness with airway equipment available.
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 Ketamine
Frequently asked questions
Can I take Ketamine with Midazolam?
MediHelp rates the interaction as moderate. Ketamine 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. The combination is used for procedural sedation, with midazolam often reducing ketamine emergence reactions. Together they can still cause deeper sedation and respiratory depression than either alone.
How serious is the interaction between Ketamine 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: Titrate each drug to effect, using reduced doses. Monitor oxygen saturation, ventilation and level of consciousness with airway equipment available.
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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