Drug interactions
Midazolam + Quinine
Severity: Moderate
Midazolam and Quinine: 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
Quinine can inhibit CYP3A4 to a modest degree and may increase midazolam exposure. This can lengthen sedation.
What this interaction means in plain words
Midazolam and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Weak inhibition of CYP3A4-mediated midazolam metabolism by quinine.
What to do
Use a reduced starting midazolam dose and titrate to effect, monitoring sedation and respiratory status through recovery.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
Frequently asked questions
Can I take Midazolam with Quinine?
MediHelp rates the interaction as moderate. Midazolam and Quinine 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. Quinine can inhibit CYP3A4 to a modest degree and may increase midazolam exposure. This can lengthen sedation.
How serious is the interaction between Midazolam and Quinine?
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 a reduced starting midazolam dose and titrate to effect, monitoring sedation and respiratory status through recovery.
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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