Drug interactions
Midazolam + Pentazocine
Severity: Major
Midazolam and Pentazocine: major 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
Midazolam with an opioid can cause deep sedation, respiratory depression, hypotension, coma and death. This is a well-recognized hazard in procedural and ward settings.
What this interaction means in plain words
Midazolam and Pentazocine 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; Pentazocine belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A potentiation.
What to do
Reduce and carefully titrate doses, and monitor oxygen saturation, respiratory rate and consciousness continuously, with resuscitation equipment available. Avoid unmonitored use outside supervised settings.
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 Pentazocine
- Calcium / magnesium / potassium / sodium oxybates + Pentazocine Contraindicated
- Olanzapine / samidorphan + Pentazocine Contraindicated
- Pentazocine + Phenelzine Contraindicated
- Pentazocine + Tranylcypromine Contraindicated
- Alfentanil + Pentazocine Major
- Alprazolam + Pentazocine Major
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 Pentazocine?
MediHelp rates the interaction as major. Midazolam and Pentazocine 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 with an opioid can cause deep sedation, respiratory depression, hypotension, coma and death. This is a well-recognized hazard in procedural and ward settings.
How serious is the interaction between Midazolam and Pentazocine?
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 and carefully titrate doses, and monitor oxygen saturation, respiratory rate and consciousness continuously, with resuscitation equipment available. Avoid unmonitored use outside supervised settings.
What other medicines interact with Pentazocine?
MediHelp also lists interactions of Pentazocine with, for example, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan, Phenelzine. The full list is on the Pentazocine page.
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