Drug interactions
Midazolam + Tizanidine
Severity: Moderate
Midazolam and Tizanidine: 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
Tizanidine is a sedating alpha-2 agonist that also lowers blood pressure, and with midazolam it can cause additive sedation, hypotension and bradycardia. The risk is higher in older or debilitated patients.
What this interaction means in plain words
Midazolam and Tizanidine 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; Tizanidine belongs to Musculoskeletal.
Why it happens
Additive CNS depression and hypotension via alpha-2 agonism and GABA-A potentiation.
What to do
Reduce the dose of one or both agents and monitor sedation, blood pressure and heart rate.
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 Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Pipemidic acid + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
Frequently asked questions
Can I take Midazolam with Tizanidine?
MediHelp rates the interaction as moderate. Midazolam and Tizanidine 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. Tizanidine is a sedating alpha-2 agonist that also lowers blood pressure, and with midazolam it can cause additive sedation, hypotension and bradycardia. The risk is higher in older or debilitated patients.
How serious is the interaction between Midazolam and Tizanidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the dose of one or both agents and monitor sedation, blood pressure and heart rate.
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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