Drug interactions
Lacosamide + Midazolam
Severity: Moderate
Lacosamide 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 drugs can cause drowsiness, dizziness and impaired coordination, and combined use may increase sedation. Respiratory depression is uncommon with lacosamide but additive CNS effects are possible, particularly in the elderly or with higher doses.
What this interaction means in plain words
Lacosamide 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.
Lacosamide belongs to Central Nervous System; Midazolam belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic CNS depression via different mechanisms (GABA-A potentiation and sodium channel slow inactivation).
What to do
Start with the lowest midazolam dose and monitor sedation level and respiratory status; advise patients against driving or operating machinery after dosing.
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 Lacosamide
- Lacosamide + Zuranolone Major
- Atazanavir + Lacosamide Moderate
- Carbamazepine + Lacosamide Moderate
- Cenobamate + Lacosamide Moderate
- Clarithromycin + Lacosamide Moderate
- Daridorexant + Lacosamide Moderate
Frequently asked questions
Can I take Lacosamide with Midazolam?
MediHelp rates the interaction as moderate. Lacosamide 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 drugs can cause drowsiness, dizziness and impaired coordination, and combined use may increase sedation. Respiratory depression is uncommon with lacosamide but additive CNS effects are possible, particularly in the elderly or with higher doses.
How serious is the interaction between Lacosamide 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: Start with the lowest midazolam dose and monitor sedation level and respiratory status; advise patients against driving or operating machinery after dosing.
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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