Drug interactions
Midazolam + Stiripentol
Severity: Major
Midazolam and Stiripentol: major 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
Stiripentol inhibits several CYP enzymes including CYP3A4 and may substantially increase midazolam exposure. Excessive sedation and respiratory depression can result, particularly with oral or intranasal midazolam.
What this interaction means in plain words
Midazolam and Stiripentol 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; Stiripentol belongs to Central Nervous System.
Why it happens
Stiripentol inhibits CYP3A4 (and other CYPs), decreasing midazolam clearance.
What to do
Use a reduced midazolam dose and monitor sedation and respiratory function closely, with extended observation after dosing. Consider an alternative rescue benzodiazepine if feasible.
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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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 Stiripentol
Frequently asked questions
Can I take Midazolam with Stiripentol?
MediHelp rates the interaction as major. Midazolam and Stiripentol 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. Stiripentol inhibits several CYP enzymes including CYP3A4 and may substantially increase midazolam exposure. Excessive sedation and respiratory depression can result, particularly with oral or intranasal midazolam.
How serious is the interaction between Midazolam and Stiripentol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a reduced midazolam dose and monitor sedation and respiratory function closely, with extended observation after dosing. Consider an alternative rescue benzodiazepine if feasible.
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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