Drug interactions
Miconazole vaginal + Midazolam
Severity: Minor
Miconazole vaginal 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
Miconazole is a CYP3A4 inhibitor and systemic absorption from vaginal use is low but not zero. It may modestly raise midazolam exposure, with prolonged sedation possible, especially with oral midazolam.
What this interaction means in plain words
Miconazole vaginal 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.
Why it happens
Inhibition of CYP3A4-mediated midazolam metabolism by absorbed miconazole.
What to do
No routine adjustment; watch for prolonged sedation if oral midazolam is given during frequent or prolonged miconazole use.
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
Frequently asked questions
Can I take Miconazole vaginal with Midazolam?
MediHelp rates the interaction as minor. Miconazole vaginal 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. Miconazole is a CYP3A4 inhibitor and systemic absorption from vaginal use is low but not zero. It may modestly raise midazolam exposure, with prolonged sedation possible, especially with oral midazolam.
How serious is the interaction between Miconazole vaginal 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 adjustment; watch for prolonged sedation if oral midazolam is given during frequent or prolonged miconazole use.
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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