Drug interactions
Midazolam + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Contraindicated
Midazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir: 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
The ritonavir-boosted regimen inhibits CYP3A4 and can markedly raise midazolam levels. Prolonged sedation and respiratory depression are possible, particularly with oral or repeated dosing.
What this interaction means in plain words
Midazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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.
Why it happens
Ritonavir and paritaprevir inhibit CYP3A4 metabolism of midazolam.
What to do
Avoid oral midazolam. If single-dose parenteral use is required, reduce the dose and monitor sedation and breathing.
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
Frequently asked questions
Can I take Midazolam with Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as contraindicated. Midazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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. The ritonavir-boosted regimen inhibits CYP3A4 and can markedly raise midazolam levels. Prolonged sedation and respiratory depression are possible, particularly with oral or repeated dosing.
How serious is the interaction between Midazolam and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
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. If single-dose parenteral use is required, reduce the dose and monitor sedation and breathing.
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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