Drug interactions
Propofol + Remimazolam
Severity: Major
Propofol and Remimazolam: 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
Remimazolam and propofol both depress the CNS, and together they produce additive sedation, hypotension and respiratory depression. This can cause oversedation and airway compromise.
What this interaction means in plain words
Propofol 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.
Propofol belongs to Central Nervous System; Remimazolam belongs to Central Nervous System.
Why it happens
Additive CNS depression through GABA-A receptor potentiation by both agents.
What to do
Give each agent only in a monitored setting by trained staff, with continuous pulse oximetry, capnography where available, and blood pressure monitoring. Titrate to effect and expect to reduce the doses of both agents.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Propofol and Remimazolam, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Remimazolam
Other interactions of Propofol
Frequently asked questions
Can I take Propofol with Remimazolam?
MediHelp rates the interaction as major. Propofol 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 and propofol both depress the CNS, and together they produce additive sedation, hypotension and respiratory depression. This can cause oversedation and airway compromise.
How serious is the interaction between Propofol 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: Give each agent only in a monitored setting by trained staff, with continuous pulse oximetry, capnography where available, and blood pressure monitoring. Titrate to effect and expect to reduce the doses of both agents.
What other medicines interact with Remimazolam?
MediHelp also lists interactions of Remimazolam with, for example, Alprazolam, Amobarbital, Asenapine. The full list is on the Remimazolam page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
