Drug interactions
Midazolam + Quinidine
Severity: Moderate
Midazolam and Quinidine: 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
Quinidine is a CYP3A4 substrate and weak inhibitor, and it may modestly raise midazolam levels. Sedation could be prolonged, and quinidine's QT effects are a separate concern in sedated patients.
What this interaction means in plain words
Midazolam and Quinidine 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; Quinidine belongs to Anti Parasitic.
Why it happens
Competitive inhibition of CYP3A4-mediated midazolam metabolism by quinidine.
What to do
Titrate midazolam cautiously and monitor sedation and respiration; keep ECG monitoring in place for patients on quinidine.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
Frequently asked questions
Can I take Midazolam with Quinidine?
MediHelp rates the interaction as moderate. Midazolam and Quinidine 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. Quinidine is a CYP3A4 substrate and weak inhibitor, and it may modestly raise midazolam levels. Sedation could be prolonged, and quinidine's QT effects are a separate concern in sedated patients.
How serious is the interaction between Midazolam and Quinidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate midazolam cautiously and monitor sedation and respiration; keep ECG monitoring in place for patients on quinidine.
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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