Drug interactions
Midazolam + Ranolazine
Severity: Moderate
Midazolam and Ranolazine: 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
Ranolazine is a weak CYP3A4 inhibitor and can modestly increase exposure to CYP3A4 substrates such as midazolam. Sedation may be somewhat prolonged.
What this interaction means in plain words
Midazolam and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Weak inhibition of CYP3A4 by ranolazine reduces midazolam clearance.
What to do
Titrate midazolam to clinical effect with a conservative initial dose and monitor sedation and respiration.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Midazolam and Ranolazine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Midazolam with Ranolazine?
MediHelp rates the interaction as moderate. Midazolam and Ranolazine 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. Ranolazine is a weak CYP3A4 inhibitor and can modestly increase exposure to CYP3A4 substrates such as midazolam. Sedation may be somewhat prolonged.
How serious is the interaction between Midazolam and Ranolazine?
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 to clinical effect with a conservative initial dose and monitor sedation and respiration.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
