Drug interactions
Meperidine + Midazolam intranasal
Severity: Major
Meperidine and Midazolam intranasal: major 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
Opioids combined with benzodiazepines cause additive sedation, respiratory depression, coma and death. Intranasal midazolam has rapid absorption, which may increase the risk when combined with an opioid.
What this interaction means in plain words
Meperidine and Midazolam intranasal 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 via opioid receptor agonism and GABA-A receptor potentiation.
What to do
Reserve the combination for patients without adequate alternatives, with the lowest doses and shortest durations. Monitor respiratory rate, oxygen saturation and sedation level.
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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Other interactions of Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Meperidine with Midazolam intranasal?
MediHelp rates the interaction as major. Meperidine and Midazolam intranasal 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. Opioids combined with benzodiazepines cause additive sedation, respiratory depression, coma and death. Intranasal midazolam has rapid absorption, which may increase the risk when combined with an opioid.
How serious is the interaction between Meperidine and Midazolam intranasal?
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 without adequate alternatives, with the lowest doses and shortest durations. Monitor respiratory rate, oxygen saturation and sedation level.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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