Drug interactions
Midazolam + Morphine
Severity: Major
Midazolam and Morphine: 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
Opioids combined with benzodiazepines such as midazolam cause profound sedation, respiratory depression, coma and death. Regulators carry a boxed warning on this combination. Midazolam and morphine are often co-administered in procedural and palliative settings, where careful titration is essential.
What this interaction means in plain words
Midazolam and Morphine 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.
Midazolam belongs to Central Nervous System; Morphine belongs to Musculoskeletal.
Why it happens
Synergistic CNS and respiratory depression through opioid receptor and GABA-A receptor activity.
What to do
Reserve the combination for situations without alternatives, use the lowest doses and shortest duration, and monitor continuously with oxygen saturation and respiratory rate. Have resuscitation equipment and reversal agents 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Midazolam and Morphine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Morphine
- Alvimopan + Morphine Contraindicated
- Isocarboxazid + Morphine Contraindicated
- Morphine + Olanzapine / samidorphan Contraindicated
- Morphine + Phenelzine Contraindicated
- Morphine + Tranylcypromine Contraindicated
- Alfentanil + Morphine Major
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 Morphine?
MediHelp rates the interaction as major. Midazolam and Morphine 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 such as midazolam cause profound sedation, respiratory depression, coma and death. Regulators carry a boxed warning on this combination. Midazolam and morphine are often co-administered in procedural and palliative settings, where careful titration is essential.
How serious is the interaction between Midazolam and Morphine?
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 situations without alternatives, use the lowest doses and shortest duration, and monitor continuously with oxygen saturation and respiratory rate. Have resuscitation equipment and reversal agents available.
What other medicines interact with Morphine?
MediHelp also lists interactions of Morphine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Morphine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
