Drug interactions
Midazolam + Propofol
Severity: Major
Midazolam and Propofol: 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 markedly potentiates propofol, reducing the dose required for induction and sedation while increasing the risk of hypotension, apnea and respiratory depression.
What this interaction means in plain words
Midazolam and Propofol 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; Propofol belongs to Central Nervous System.
Why it happens
Synergistic GABA-A receptor modulation producing additive CNS and cardiorespiratory depression.
What to do
Reduce propofol dose and titrate slowly, with continuous monitoring of oxygen saturation, blood pressure and airway by trained personnel.
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 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 Propofol
Frequently asked questions
Can I take Midazolam with Propofol?
MediHelp rates the interaction as major. Midazolam and Propofol 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 markedly potentiates propofol, reducing the dose required for induction and sedation while increasing the risk of hypotension, apnea and respiratory depression.
How serious is the interaction between Midazolam and Propofol?
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 propofol dose and titrate slowly, with continuous monitoring of oxygen saturation, blood pressure and airway by trained personnel.
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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