Drug interactions
Midazolam + Orphenadrin
Severity: Major
Midazolam and Orphenadrin: major interaction.
Last updated Sources: UK SmPC
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
Midazolam is a potent sedative, and orphenadrine adds further central depression and anticholinergic effects. The combination can deepen sedation, impair cognition and contribute to respiratory depression, especially in older or frail patients.
What this interaction means in plain words
Midazolam and Orphenadrin 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; Orphenadrin belongs to Musculoskeletal.
Why it happens
Additive central nervous system depressant effects.
What to do
Reduce the midazolam dose and titrate to effect, with continuous monitoring of sedation level and respiratory status. Avoid the combination in outpatients or in older adults where possible.
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?
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References
Other interactions of Orphenadrin
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 Orphenadrin?
MediHelp rates the interaction as major. Midazolam and Orphenadrin 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 is a potent sedative, and orphenadrine adds further central depression and anticholinergic effects. The combination can deepen sedation, impair cognition and contribute to respiratory depression, especially in older or frail patients.
How serious is the interaction between Midazolam and Orphenadrin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the midazolam dose and titrate to effect, with continuous monitoring of sedation level and respiratory status. Avoid the combination in outpatients or in older adults where possible.
What other medicines interact with Orphenadrin?
MediHelp also lists interactions of Orphenadrin with, for example, Alfentanil, Amobarbital, Benzhydrocodone / acetaminophen. The full list is on the Orphenadrin page.
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