Drug interactions
Lenacapavir + Midazolam
Severity: Moderate
Lenacapavir 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
Lenacapavir is a moderate CYP3A inhibitor and can raise midazolam exposure, with the effect lasting for months after subcutaneous dosing. This may cause prolonged sedation and respiratory depression, particularly with oral midazolam.
What this interaction means in plain words
Lenacapavir 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.
Lenacapavir belongs to Anti Virals; Midazolam belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 by lenacapavir decreases midazolam clearance.
What to do
Use a reduced midazolam dose, particularly oral, and monitor sedation and respiratory status, remembering that the inhibition persists long after the last lenacapavir injection.
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 Lenacapavir 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 14 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 Lenacapavir
- Apalutamide + Lenacapavir Contraindicated
- Carbamazepine + Lenacapavir Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
- Flibanserin + Lenacapavir Contraindicated
- Lenacapavir + Phenytoin Contraindicated
- Lenacapavir + Rifampicin Contraindicated
Frequently asked questions
Can I take Lenacapavir with Midazolam?
MediHelp rates the interaction as moderate. Lenacapavir 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. Lenacapavir is a moderate CYP3A inhibitor and can raise midazolam exposure, with the effect lasting for months after subcutaneous dosing. This may cause prolonged sedation and respiratory depression, particularly with oral midazolam.
How serious is the interaction between Lenacapavir 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: Use a reduced midazolam dose, particularly oral, and monitor sedation and respiratory status, remembering that the inhibition persists long after the last lenacapavir injection.
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.
