Drug interactions
Midazolam + Pheniramine
Severity: Moderate
Midazolam and Pheniramine: 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
Pheniramine is a first-generation sedating antihistamine, and combined with midazolam it can produce additive drowsiness, psychomotor impairment and, at higher doses, respiratory depression. Elderly patients are particularly vulnerable to confusion and falls.
What this interaction means in plain words
Midazolam and Pheniramine 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; Pheniramine belongs to Respiratory.
Why it happens
Additive CNS depression from central H1 antagonism and GABA-A potentiation.
What to do
Reduce the midazolam dose, titrate carefully, and monitor sedation and respiratory rate; avoid in frail patients if alternatives exist.
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 Pheniramine
- Amisulpride + Pheniramine Moderate
- Asenapine + Pheniramine Moderate
- Brexpiprazole + Pheniramine Moderate
- Brivaracetam + Pheniramine Moderate
- Cariprazine + Pheniramine Moderate
- Fentanyl + Pheniramine Moderate
Frequently asked questions
Can I take Midazolam with Pheniramine?
MediHelp rates the interaction as moderate. Midazolam and Pheniramine 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. Pheniramine is a first-generation sedating antihistamine, and combined with midazolam it can produce additive drowsiness, psychomotor impairment and, at higher doses, respiratory depression. Elderly patients are particularly vulnerable to confusion and falls.
How serious is the interaction between Midazolam and Pheniramine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the midazolam dose, titrate carefully, and monitor sedation and respiratory rate; avoid in frail patients if alternatives exist.
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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