Drug interactions
Midazolam intranasal + Orphenadrin
Severity: Moderate
Midazolam intranasal and Orphenadrin: 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
Orphenadrine is a sedating anticholinergic muscle relaxant, and combining it with intranasal midazolam adds to CNS and respiratory depression. Hypoventilation, airway obstruction or oxygen desaturation may occur, and sedation may last longer than expected.
What this interaction means in plain words
Midazolam intranasal and Orphenadrin 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.
Why it happens
Additive CNS depressant effects; a weak CYP3A4 inhibitory effect of orphenadrine on midazolam metabolism is also suggested but not well established.
What to do
Monitor sedation level, respiratory rate and oxygen saturation after midazolam dosing. Avoid repeat midazolam doses until the effect of the first dose has been assessed.
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 Orphenadrin
Frequently asked questions
Can I take Midazolam intranasal with Orphenadrin?
MediHelp rates the interaction as moderate. Midazolam intranasal and Orphenadrin 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. Orphenadrine is a sedating anticholinergic muscle relaxant, and combining it with intranasal midazolam adds to CNS and respiratory depression. Hypoventilation, airway obstruction or oxygen desaturation may occur, and sedation may last longer than expected.
How serious is the interaction between Midazolam intranasal and Orphenadrin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation level, respiratory rate and oxygen saturation after midazolam dosing. Avoid repeat midazolam doses until the effect of the first dose has been assessed.
What other medicines interact with Orphenadrin?
MediHelp also lists interactions of Orphenadrin with, for example, Alfentanil, Amobarbital, Benzhydrocodone / acetaminophen. The full list is on the Orphenadrin page.
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