Drug interactions
Pregabalin + Remimazolam
Severity: Major
Pregabalin and Remimazolam: 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
Remimazolam is an ultra-short-acting procedural benzodiazepine, and pregabalin adds CNS depressant effects. The combination can increase the depth of sedation and the risk of hypoventilation or apnea during procedures.
What this interaction means in plain words
Pregabalin and Remimazolam 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.
Pregabalin belongs to Central Nervous System; Remimazolam belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic CNS and respiratory depression.
What to do
Titrate remimazolam carefully, usually at reduced doses, and monitor continuously with pulse oximetry and capnography. Ensure airway support and reversal agents are available.
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
- Alzain 100 mg Capsules, Hard - SmPC sections 4.3/4.5 (class statement: central nervous system (CNS) depressant medicinal products; "there are reports of respiratory failure, coma and deaths in patients taking pregabalin and opioids and/or other central nervous system (CNS) depressant medicin") — electronic medicines compendium (UK SmPC)
Other interactions of Pregabalin
Other interactions of Remimazolam
Frequently asked questions
Can I take Pregabalin with Remimazolam?
MediHelp rates the interaction as major. Pregabalin and Remimazolam 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. Remimazolam is an ultra-short-acting procedural benzodiazepine, and pregabalin adds CNS depressant effects. The combination can increase the depth of sedation and the risk of hypoventilation or apnea during procedures.
How serious is the interaction between Pregabalin and Remimazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate remimazolam carefully, usually at reduced doses, and monitor continuously with pulse oximetry and capnography. Ensure airway support and reversal agents are available.
What other medicines interact with Pregabalin?
MediHelp also lists interactions of Pregabalin with, for example, Alprazolam, Amobarbital, Belladonna and opium. The full list is on the Pregabalin page.
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