Drug interactions
Midazolam intranasal + Oxazepam
Severity: Major
Midazolam intranasal and Oxazepam: 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
Oral oxazepam combined with intranasal midazolam adds benzodiazepine effects and can cause deep or prolonged sedation, hypoventilation and apnea. The risk is greater in the elderly and in patients with respiratory compromise.
What this interaction means in plain words
Midazolam intranasal and Oxazepam 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 GABA-A receptor-mediated CNS and respiratory depression from two benzodiazepines.
What to do
Avoid giving together unless clinically essential; if used, reduce the midazolam dose and monitor respiratory rate, oxygen saturation and level of consciousness until recovery.
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 Oxazepam
- Calcium / magnesium / potassium / sodium oxybates + Oxazepam Contraindicated
- Oxazepam + Sodium oxybate Contraindicated
- Alfentanil + Oxazepam Major
- Amobarbital + Oxazepam Major
- Baclofen + Oxazepam Major
- Belladonna and opium + Oxazepam Major
Frequently asked questions
Can I take Midazolam intranasal with Oxazepam?
MediHelp rates the interaction as major. Midazolam intranasal and Oxazepam 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. Oral oxazepam combined with intranasal midazolam adds benzodiazepine effects and can cause deep or prolonged sedation, hypoventilation and apnea. The risk is greater in the elderly and in patients with respiratory compromise.
How serious is the interaction between Midazolam intranasal and Oxazepam?
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 giving together unless clinically essential; if used, reduce the midazolam dose and monitor respiratory rate, oxygen saturation and level of consciousness until recovery.
What other medicines interact with Oxazepam?
MediHelp also lists interactions of Oxazepam with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Oxazepam page.
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