Drug interactions
Midazolam + Pimavanserin
Severity: Moderate
Midazolam and Pimavanserin: 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
Pimavanserin can cause somnolence and confusion, which may add to midazolam sedation. The combination is mainly of concern in older patients with Parkinson's disease psychosis who are prone to falls and delirium.
What this interaction means in plain words
Midazolam and Pimavanserin 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; Pimavanserin belongs to Central Nervous System.
Why it happens
Additive CNS depression; pimavanserin is a serotonin 5-HT2A inverse agonist with sedating effects.
What to do
Use the lowest midazolam dose and monitor sedation, confusion and fall risk.
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 Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin Major
Frequently asked questions
Can I take Midazolam with Pimavanserin?
MediHelp rates the interaction as moderate. Midazolam and Pimavanserin 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. Pimavanserin can cause somnolence and confusion, which may add to midazolam sedation. The combination is mainly of concern in older patients with Parkinson's disease psychosis who are prone to falls and delirium.
How serious is the interaction between Midazolam and Pimavanserin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest midazolam dose and monitor sedation, confusion and fall risk.
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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