Drug interactions
Midazolam + Protriptyline
Severity: Moderate
Midazolam and Protriptyline: 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
Combining midazolam with the tricyclic antidepressant protriptyline can increase drowsiness, psychomotor impairment and respiratory depression. The risk is greater in older patients and with higher doses.
What this interaction means in plain words
Midazolam and Protriptyline 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.
Why it happens
Additive CNS depression from benzodiazepine GABA-A potentiation and tricyclic antihistaminic/anticholinergic effects.
What to do
Use the lowest effective midazolam dose and monitor level of sedation and respiration. Counsel patients to avoid driving and alcohol.
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
Frequently asked questions
Can I take Midazolam with Protriptyline?
MediHelp rates the interaction as moderate. Midazolam and Protriptyline 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. Combining midazolam with the tricyclic antidepressant protriptyline can increase drowsiness, psychomotor impairment and respiratory depression. The risk is greater in older patients and with higher doses.
How serious is the interaction between Midazolam and Protriptyline?
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 effective midazolam dose and monitor level of sedation and respiration. Counsel patients to avoid driving and alcohol.
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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