Drug interactions
Midazolam + Nortriptyline
Severity: Moderate
Midazolam and Nortriptyline: 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
Nortriptyline has sedative and anticholinergic effects that add to those of midazolam, increasing drowsiness and impaired coordination. Overdose or high doses may increase risk of respiratory depression.
What this interaction means in plain words
Midazolam and Nortriptyline 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.
Midazolam belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive CNS depression through different receptor mechanisms.
What to do
Start with reduced midazolam doses and monitor sedation and breathing; warn patients about driving and falls.
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?
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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
Other interactions of Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Midazolam with Nortriptyline?
MediHelp rates the interaction as moderate. Midazolam and Nortriptyline 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. Nortriptyline has sedative and anticholinergic effects that add to those of midazolam, increasing drowsiness and impaired coordination. Overdose or high doses may increase risk of respiratory depression.
How serious is the interaction between Midazolam and Nortriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with reduced midazolam doses and monitor sedation and breathing; warn patients about driving and falls.
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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