Drug interactions
Midazolam + Zuranolone
Severity: Major
Midazolam and Zuranolone: 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
Both drugs depress the CNS, and combined use increases sedation and psychomotor impairment. Zuranolone is labeled with a driving impairment warning.
What this interaction means in plain words
Midazolam and Zuranolone 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; Zuranolone belongs to Central Nervous System.
Why it happens
Additive CNS depression through positive modulation of GABA-A receptors.
What to do
Reduce zuranolone dose if sedation occurs and use the lowest effective midazolam dose. Monitor sedation and advise patients not to drive.
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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References
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 Zuranolone
- Alprazolam + Zuranolone Major
- Amobarbital + Zuranolone Major
- Apalutamide + Zuranolone Major
- Asenapine + Zuranolone Major
- Brexpiprazole + Zuranolone Major
- Butorphanol + Zuranolone Major
Frequently asked questions
Can I take Midazolam with Zuranolone?
MediHelp rates the interaction as major. Midazolam and Zuranolone 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. Both drugs depress the CNS, and combined use increases sedation and psychomotor impairment. Zuranolone is labeled with a driving impairment warning.
How serious is the interaction between Midazolam and Zuranolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce zuranolone dose if sedation occurs and use the lowest effective midazolam dose. Monitor sedation and advise patients not to drive.
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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