Drug interactions
Midazolam + Midazolam intranasal
Severity: Major
Midazolam and Midazolam intranasal: 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
These are the same active substance in different formulations, so combined dosing adds up to a duplicate exposure and overdose risk. Excess midazolam may cause hypoventilation, airway obstruction and apnea.
What this interaction means in plain words
Midazolam 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 effect of duplicate benzodiazepine dosing at GABA-A receptors.
What to do
Avoid duplicate midazolam administration and count all routes toward total dose. Monitor respiration and oxygen saturation if both are given.
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 Midazolam with Midazolam intranasal?
MediHelp rates the interaction as major. Midazolam 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. These are the same active substance in different formulations, so combined dosing adds up to a duplicate exposure and overdose risk. Excess midazolam may cause hypoventilation, airway obstruction and apnea.
How serious is the interaction between Midazolam 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: Avoid duplicate midazolam administration and count all routes toward total dose. Monitor respiration and oxygen saturation if both are given.
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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