Drug interactions
Midazolam + Nelfinavir
Severity: Contraindicated
Midazolam and Nelfinavir: contraindicated 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
Nelfinavir inhibits CYP3A4 and can substantially increase midazolam concentrations. Prolonged sedation and respiratory depression can occur.
What this interaction means in plain words
Midazolam and Nelfinavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Midazolam belongs to Central Nervous System; Nelfinavir belongs to Anti Virals.
Why it happens
Nelfinavir inhibits CYP3A4-mediated midazolam metabolism.
What to do
Avoid oral midazolam. Single parenteral doses require dose reduction and monitored conditions; consider a non-CYP3A benzodiazepine such as lorazepam.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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
Other interactions of Nelfinavir
- Alfuzosin + Nelfinavir Contraindicated
- Avanafil + Nelfinavir Contraindicated
- Dronedarone + Nelfinavir Contraindicated
- Eletriptan + Nelfinavir Contraindicated
- Ergotamine + Nelfinavir Contraindicated
- Flibanserin + Nelfinavir Contraindicated
Frequently asked questions
Can I take Midazolam with Nelfinavir?
MediHelp rates the interaction as contraindicated. Midazolam and Nelfinavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Nelfinavir inhibits CYP3A4 and can substantially increase midazolam concentrations. Prolonged sedation and respiratory depression can occur.
How serious is the interaction between Midazolam and Nelfinavir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid oral midazolam. Single parenteral doses require dose reduction and monitored conditions; consider a non-CYP3A benzodiazepine such as lorazepam.
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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