Drug interactions
Midazolam intranasal + Quetiapine
Severity: Major
Midazolam intranasal and Quetiapine: 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
Midazolam is a benzodiazepine and quetiapine is sedating, so together they can cause profound sedation and respiratory depression. Hypoventilation or apnea can occur, particularly in higher-risk patients.
What this interaction means in plain words
Midazolam intranasal and Quetiapine 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 GABA-A potentiation and quetiapine's sedative receptor effects.
What to do
Monitor respiratory rate, oxygen saturation and level of consciousness after dosing, with resuscitation equipment available. Avoid additional sedatives and reduce the midazolam dose where appropriate.
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 Quetiapine
- Adagrasib + Quetiapine Major
- Amiodarone + Quetiapine Major
- Amisulpride + Quetiapine Major
- Amoxapine + Quetiapine Major
- Anagrelide + Quetiapine Major
- Apalutamide + Quetiapine Major
Frequently asked questions
Can I take Midazolam intranasal with Quetiapine?
MediHelp rates the interaction as major. Midazolam intranasal and Quetiapine 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 is a benzodiazepine and quetiapine is sedating, so together they can cause profound sedation and respiratory depression. Hypoventilation or apnea can occur, particularly in higher-risk patients.
How serious is the interaction between Midazolam intranasal and Quetiapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor respiratory rate, oxygen saturation and level of consciousness after dosing, with resuscitation equipment available. Avoid additional sedatives and reduce the midazolam dose where appropriate.
What other medicines interact with Quetiapine?
MediHelp also lists interactions of Quetiapine with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Quetiapine page.
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