Drug interactions
Midazolam intranasal + Ramelteon
Severity: Moderate
Midazolam intranasal and Ramelteon: 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
Midazolam produces dose-dependent sedation and respiratory depression, and other sedative agents may intensify and prolong this. Ramelteon has weak sedative effects, so the added risk is modest but relevant in vulnerable patients.
What this interaction means in plain words
Midazolam intranasal and Ramelteon 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.
What to do
Monitor sedation and respiratory status after midazolam administration. Avoid repeat dosing until the first dose has taken full effect.
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 Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
Frequently asked questions
Can I take Midazolam intranasal with Ramelteon?
MediHelp rates the interaction as moderate. Midazolam intranasal and Ramelteon 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. Midazolam produces dose-dependent sedation and respiratory depression, and other sedative agents may intensify and prolong this. Ramelteon has weak sedative effects, so the added risk is modest but relevant in vulnerable patients.
How serious is the interaction between Midazolam intranasal and Ramelteon?
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 and respiratory status after midazolam administration. Avoid repeat dosing until the first dose has taken full effect.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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