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Drug interactions

Midazolam + Nafcillin

Severity: Moderate

Midazolam and Nafcillin: moderate 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

Nafcillin is a CYP3A4 inducer and may reduce midazolam concentrations, lowering its sedative effect. The effect is documented mainly for other CYP3A4 substrates and develops over days.

What this interaction means in plain words

Midazolam and Nafcillin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Evidence level: Low

Why it happens

Induction of CYP3A4 by nafcillin, increasing midazolam metabolism.

What to do

Titrate midazolam to clinical effect and expect higher dose needs during prolonged nafcillin therapy.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Midazolam with Nafcillin?

MediHelp rates the interaction as moderate. Midazolam and Nafcillin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Nafcillin is a CYP3A4 inducer and may reduce midazolam concentrations, lowering its sedative effect. The effect is documented mainly for other CYP3A4 substrates and develops over days.

How serious is the interaction between Midazolam and Nafcillin?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate midazolam to clinical effect and expect higher dose needs during prolonged nafcillin therapy.

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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