Drug interactions
Larotrectinib + Midazolam
Severity: Moderate
Larotrectinib 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
Larotrectinib is a CYP3A4 substrate and can moderately inhibit CYP3A4, which may raise midazolam concentrations. This could lead to deeper or longer sedation.
What this interaction means in plain words
Larotrectinib 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.
Larotrectinib belongs to Oncology; Midazolam belongs to Central Nervous System.
Why it happens
Larotrectinib inhibits CYP3A4, reducing midazolam clearance.
What to do
Monitor sedation and respiratory function, and reduce the midazolam dose if needed. Use particular care with oral midazolam.
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 Larotrectinib
Frequently asked questions
Can I take Larotrectinib with Midazolam?
MediHelp rates the interaction as moderate. Larotrectinib 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. Larotrectinib is a CYP3A4 substrate and can moderately inhibit CYP3A4, which may raise midazolam concentrations. This could lead to deeper or longer sedation.
How serious is the interaction between Larotrectinib 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: Monitor sedation and respiratory function, and reduce the midazolam dose if needed. Use particular care with oral midazolam.
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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