Drug interactions
Midazolam + Valproic acid
Severity: Moderate
Midazolam and Valproic acid: 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 can deepen sedation and, with intranasal or parenteral midazolam, raise the risk of hypoventilation or apnea. Valproate may also displace benzodiazepines from protein binding, adding to the effect.
What this interaction means in plain words
Midazolam and Valproic acid 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; Valproic acid belongs to Central Nervous System.
Why it happens
Additive CNS depression, with possible protein-binding displacement and reduced benzodiazepine clearance by valproate.
What to do
Use the lowest effective midazolam dose and monitor sedation level, respiratory rate and oxygen saturation after administration.
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 Valproic acid
- Ertapenem + Valproic acid Contraindicated
- Imipenem / cilastatin / relebactam + Valproic acid Contraindicated
- Imipenem / cilastatin + Valproic acid Contraindicated
- Meropenem / vaborbactam + Valproic acid Contraindicated
- Meropenem + Valproic acid Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Valproic acid Major
Frequently asked questions
Can I take Midazolam with Valproic acid?
MediHelp rates the interaction as moderate. Midazolam and Valproic acid 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 can deepen sedation and, with intranasal or parenteral midazolam, raise the risk of hypoventilation or apnea. Valproate may also displace benzodiazepines from protein binding, adding to the effect.
How serious is the interaction between Midazolam and Valproic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective midazolam dose and monitor sedation level, respiratory rate and oxygen saturation after administration.
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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