Drug interactions
Lidocaine + Midazolam
Severity: Minor
Lidocaine and Midazolam: minor 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
Lidocaine is a weak CYP3A4 substrate and may modestly reduce midazolam clearance. Exposure to midazolam may rise slightly, which could lengthen sedation in some patients.
What this interaction means in plain words
Lidocaine and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Lidocaine belongs to Cardiovascular; Midazolam belongs to Central Nervous System.
Why it happens
Weak competitive inhibition of CYP3A4-mediated midazolam metabolism.
What to do
No routine dose change is needed; titrate midazolam to clinical sedation level and monitor recovery when lidocaine is given systemically.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Lidocaine
- Bupivacaine liposome + Lidocaine Major
- Disopyramide + Lidocaine Major
- Ex vivo expanded autologous human corneal epithelial cells containing stem cells + Lidocaine Major
- Lidocaine + Nirmatrelvir / ritonavir Major
- Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir Major
- Lidocaine + Pimozide Major
Frequently asked questions
Can I take Lidocaine with Midazolam?
MediHelp rates the interaction as minor. Lidocaine and Midazolam have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Lidocaine is a weak CYP3A4 substrate and may modestly reduce midazolam clearance. Exposure to midazolam may rise slightly, which could lengthen sedation in some patients.
How serious is the interaction between Lidocaine and Midazolam?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed; titrate midazolam to clinical sedation level and monitor recovery when lidocaine is given systemically.
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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