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Drug interactions

Midazolam + Zaleplon

Severity: Major

Midazolam and Zaleplon: 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

Zaleplon is a sedative-hypnotic that acts at the GABA-A receptor, so combining it with midazolam produces additive sedation and psychomotor impairment. Complex sleep behaviors, falls and respiratory depression are more likely, especially in older patients.

What this interaction means in plain words

Midazolam and Zaleplon 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; Zaleplon belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive GABA-A receptor-mediated CNS and respiratory depression.

What to do

Avoid combined use where possible; if needed, reduce doses, hold zaleplon around procedural midazolam, and monitor sedation and respiration.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Midazolam with Zaleplon?

MediHelp rates the interaction as major. Midazolam and Zaleplon 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. Zaleplon is a sedative-hypnotic that acts at the GABA-A receptor, so combining it with midazolam produces additive sedation and psychomotor impairment. Complex sleep behaviors, falls and respiratory depression are more likely, especially in older patients.

How serious is the interaction between Midazolam and Zaleplon?

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 combined use where possible; if needed, reduce doses, hold zaleplon around procedural midazolam, and monitor sedation and respiration.

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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