Dormizin Drug Interactions

Enhancement of the central depressive effect may occur when Midazolam is used concomitantly with antipsychotics (neuroleptics), hypnotics, anxiolytics/sedatives, antidepressants, narcotic analgesics, antiepileptic drugs, anesthetics and sedative antihistamines.
There is a potentially relevant interaction between midazolam and compounds which inhibit certain hepatic enzymes (particularly cytochrome P-450 IIIA). Data clearly indicate that these compounds influence the pharmacokinetics of midazolam and that this may lead to prolonged sedation. At present, this reaction is known to occur in vivo with ketoconazole, itraconazole, erythromycin, diltiazem, verapamil, cimetidine and ranitidine (tablet), but not with cyclosporin (ampoule) and nitrendipine (ampoule).
Therefore, patients receiving the previously mentioned compounds or others which inhibit P-450 IIIA together with midazolam IV should be monitored carefully for the first few hours after administration of midazolam. (Studies have shown that ranitidine has no significant effect on the pharmacokinetics of IV given midazolam.)
One in vitro study has shown the hydroxylation of midazolam to be inhibited by a number of other substances (eg, amiodarone, neuroleptics); accordingly, interaction with a whole range of medicaments is theoretically possible. However, there is no evidence that these results are of clinical relevance.
Alcohol may enhance the sedative effect of midazolam.