Drug interactions
Midazolam + Perampanel
Severity: Moderate
Midazolam and Perampanel: 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
Perampanel can cause somnolence, dizziness and impaired coordination, which add to midazolam effects. Perampanel may also slightly lower midazolam exposure through enzyme induction.
What this interaction means in plain words
Midazolam and Perampanel 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; Perampanel belongs to Central Nervous System.
Why it happens
Additive CNS depression; perampanel has weak CYP3A4 induction at higher doses.
What to do
Monitor sedation and psychomotor function and titrate midazolam to effect; warn patients about driving and hazardous activities.
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 Perampanel
- Apalutamide + Perampanel Major
- Enzalutamide + Perampanel Major
- Alprazolam + Perampanel Moderate
- Amisulpride + Perampanel Moderate
- Amobarbital + Perampanel Moderate
- Asenapine + Perampanel Moderate
Frequently asked questions
Can I take Midazolam with Perampanel?
MediHelp rates the interaction as moderate. Midazolam and Perampanel 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. Perampanel can cause somnolence, dizziness and impaired coordination, which add to midazolam effects. Perampanel may also slightly lower midazolam exposure through enzyme induction.
How serious is the interaction between Midazolam and Perampanel?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and psychomotor function and titrate midazolam to effect; warn patients about driving and hazardous activities.
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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