Drug interactions
Midazolam + Secobarbital
Severity: Major
Midazolam and Secobarbital: major interaction.
Last updated Sources: US FDA label
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
Secobarbital adds to midazolam CNS and respiratory depression. With repeated use it also induces midazolam metabolism, which may reduce efficacy and make the net effect unpredictable.
What this interaction means in plain words
Midazolam and Secobarbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Midazolam belongs to Central Nervous System; Secobarbital belongs to Central Nervous System.
Why it happens
Additive GABA-A mediated CNS depression plus CYP3A4 induction by barbiturates.
What to do
Avoid combining where possible; if necessary, titrate midazolam carefully and monitor respiration and sedation with airway support available.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Secobarbital
- Calcium / magnesium / potassium / sodium oxybates + Secobarbital Contraindicated
- Doravirine + Secobarbital Contraindicated
- Elbasvir / grazoprevir + Secobarbital Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Secobarbital Contraindicated
- Isavuconazonium + Secobarbital Contraindicated
- Lonafarnib + Secobarbital Contraindicated
Frequently asked questions
Can I take Midazolam with Secobarbital?
MediHelp rates the interaction as major. Midazolam and Secobarbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Secobarbital adds to midazolam CNS and respiratory depression. With repeated use it also induces midazolam metabolism, which may reduce efficacy and make the net effect unpredictable.
How serious is the interaction between Midazolam and Secobarbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible; if necessary, titrate midazolam carefully and monitor respiration and sedation with airway support available.
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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