Drug interactions
Midazolam intranasal + Nabilone
Severity: Major
Midazolam intranasal and Nabilone: major interaction.
Last updated Sources: UK SmPC
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, so combination can deepen sedation and, with midazolam, may increase the risk of hypoventilation and apnea. Impaired psychomotor performance may last longer than expected.
What this interaction means in plain words
Midazolam intranasal and Nabilone 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.
Why it happens
Additive CNS and respiratory depression from cannabinoid agonism and GABA-A potentiation.
What to do
Use the lowest effective midazolam dose and monitor respiratory rate, oxygen saturation and sedation level. Avoid additional CNS depressants and alcohol.
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
- Nabilone 0.25mg Capsule - SmPC sections 4.3/4.5 (class statement: benzodiazepines; "Barbiturates, benzodiazepines, lithium, opioids, buspirone, muscle relaxants,") — electronic medicines compendium (UK SmPC)
Other interactions of Nabilone
Frequently asked questions
Can I take Midazolam intranasal with Nabilone?
MediHelp rates the interaction as major. Midazolam intranasal and Nabilone 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, so combination can deepen sedation and, with midazolam, may increase the risk of hypoventilation and apnea. Impaired psychomotor performance may last longer than expected.
How serious is the interaction between Midazolam intranasal and Nabilone?
MediHelp rates it major, 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 respiratory rate, oxygen saturation and sedation level. Avoid additional CNS depressants and alcohol.
What other medicines interact with Nabilone?
MediHelp also lists interactions of Nabilone with, for example, Alfentanil, Amobarbital, Belladonna and opium. The full list is on the Nabilone page.
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