Drug interactions
Loxicodegol + Midazolam
Severity: Major
Loxicodegol and Midazolam: major interaction.
Last updated Sources: US FDA label
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
Loxicodegol is an opioid agonist, and combining it with a benzodiazepine such as midazolam raises the risk of profound sedation, respiratory depression, coma and death. This carries a boxed warning for opioid-benzodiazepine combinations.
What this interaction means in plain words
Loxicodegol and Midazolam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression through opioid receptor agonism and GABA-A potentiation.
What to do
Reserve the combination for patients with no adequate alternatives, using the lowest doses and shortest duration. Monitor respiratory rate, sedation and oxygen saturation closely, with naloxone available.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Loxicodegol with Midazolam?
MediHelp rates the interaction as major. Loxicodegol and Midazolam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Loxicodegol is an opioid agonist, and combining it with a benzodiazepine such as midazolam raises the risk of profound sedation, respiratory depression, coma and death. This carries a boxed warning for opioid-benzodiazepine combinations.
How serious is the interaction between Loxicodegol and Midazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve the combination for patients with no adequate alternatives, using the lowest doses and shortest duration. Monitor respiratory rate, sedation and oxygen saturation closely, with naloxone available.
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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