Drug interactions
Lefamulin + Midazolam
Severity: Moderate
Lefamulin 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
Lefamulin markedly increases systemic midazolam exposure, with roughly a threefold increase in AUC. This can lead to deeper or prolonged sedation and respiratory depression, particularly with oral dosing.
What this interaction means in plain words
Lefamulin 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.
Lefamulin belongs to Anti Bacterial; Midazolam belongs to Central Nervous System.
Why it happens
Lefamulin inhibits CYP3A4, reducing midazolam metabolism.
What to do
Monitor for excess sedation and respiratory depression, and consider reducing the midazolam dose. Use extra caution 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 Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimavanserin Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
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
Frequently asked questions
Can I take Lefamulin with Midazolam?
MediHelp rates the interaction as moderate. Lefamulin 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. Lefamulin markedly increases systemic midazolam exposure, with roughly a threefold increase in AUC. This can lead to deeper or prolonged sedation and respiratory depression, particularly with oral dosing.
How serious is the interaction between Lefamulin 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 for excess sedation and respiratory depression, and consider reducing the midazolam dose. Use extra caution with oral midazolam.
What other medicines interact with Lefamulin?
MediHelp also lists interactions of Lefamulin with, for example, Methadone, Pimavanserin, Pimozide. The full list is on the Lefamulin page.
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