Drug interactions
Midazolam + Suvorexant
Severity: Moderate
Midazolam and Suvorexant: 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
Both drugs depress the central nervous system, so combined use produces additive sedation, impaired psychomotor performance and next-day drowsiness. Respiratory depression is less likely than with opioid combinations but can be more pronounced in the elderly or in those with respiratory disease.
What this interaction means in plain words
Midazolam and Suvorexant 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; Suvorexant belongs to Central Nervous System.
Why it happens
Additive CNS depression through GABA-A potentiation by midazolam and orexin receptor antagonism by suvorexant.
What to do
Avoid routine co-prescription for insomnia. If both are needed, use the lowest effective doses and monitor sedation and psychomotor function.
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 Suvorexant
Frequently asked questions
Can I take Midazolam with Suvorexant?
MediHelp rates the interaction as moderate. Midazolam and Suvorexant 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. Both drugs depress the central nervous system, so combined use produces additive sedation, impaired psychomotor performance and next-day drowsiness. Respiratory depression is less likely than with opioid combinations but can be more pronounced in the elderly or in those with respiratory disease.
How serious is the interaction between Midazolam and Suvorexant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid routine co-prescription for insomnia. If both are needed, use the lowest effective doses and monitor sedation and psychomotor function.
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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