Drug interactions
Midazolam + Schisandra
Severity: Moderate
Midazolam and Schisandra: 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
Schisandra may inhibit intestinal and hepatic CYP3A4 and has been shown to raise midazolam exposure. This may intensify and prolong sedation and respiratory depression.
What this interaction means in plain words
Midazolam and Schisandra 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
Schisandra lignans inhibit CYP3A4, reducing first-pass and systemic midazolam metabolism.
What to do
Advise patients to avoid schisandra products around midazolam use, or reduce the midazolam dose and monitor sedation. Ask about herbal supplement use before procedural sedation.
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 Schisandra?
MediHelp rates the interaction as moderate. Midazolam and Schisandra 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. Schisandra may inhibit intestinal and hepatic CYP3A4 and has been shown to raise midazolam exposure. This may intensify and prolong sedation and respiratory depression.
How serious is the interaction between Midazolam and Schisandra?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid schisandra products around midazolam use, or reduce the midazolam dose and monitor sedation. Ask about herbal supplement use before procedural sedation.
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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