Applies to chronic use with PO midazolamindinavirindinavir increases levels of midazolam by decreasing metabolism. Contraindicated.ivosidenibivosidenib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.ketoconazoleketoconazole will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.ketoconazole increases levels of midazolam by decreasing metabolism. Contraindicated.levoketoconazolelevoketoconazole will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.levoketoconazole increases levels of midazolam by decreasing metabolism. Contraindicated.lopinavirlopinavir will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.lorlatiniblorlatinib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid use of lorlatinib with CYP3A substrates, where minimal concentration changes may lead to serious therapeutic failures of the substrate. If concomitant use is unavoidable, increase CYP3A substrate dosage in accordance with approved product labeling.lumacaftor/ivacaftorlumacaftor/ivacaftor will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Lumacaftor is a strong inducer of CYP3A. Avoid coadministration with sensitive CYP3A substrates or CYP3A substrates with a narrow therapeutic index.metoclopramide intranasalmidazolam, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.mobocertinibmobocertinib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use is unavoidable, increase CYP3A4 substrate dosage in accordance with its prescribing information.nefazodonenefazodone will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.olopatadine intranasalmidazolam and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. olutasidenibolutasidenib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of olutasidenib (a CYP3A4 inducer) with sensitive CYP3A substrates unless otherwise instructed in substrates prescribing information. If unavoidable, monitor for loss of therapeutic effect of sensitive CYP3A4 substrates.pacritinibpacritinib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.pexidartinibpexidartinib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of pexidartinib (a CYP3A4 inducer) with sensitive CYP3A substrates may lead to serious therapeutic failures. If concomitant use is unavoidable, increase the CYP3A substrate dosage in accordance with approved product labeling.rifabutinrifabutin will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.rifampinrifampin will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.ritonavirritonavir increases levels of midazolam by decreasing metabolism. Contraindicated.saquinavirsaquinavir increases levels of midazolam by decreasing metabolism. Contraindicated.saquinavir will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.selinexorselinexor, midazolam. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sodium oxybatemidazolam, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.sotorasibsotorasib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the CYP3A4 substrate for dosage modificationsSt John's WortSt John's Wort will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.sufentanil SLsufentanil SL, midazolam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.tipranavirtipranavir increases levels of midazolam by decreasing metabolism. Contraindicated.tipranavir will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.tucatinibtucatinib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.valerianvalerian and midazolam both increase sedation. Avoid or Use Alternate Drug.voxelotorvoxelotor will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.Monitor Closely (299)acrivastineacrivastine and midazolam both increase sedation. Use Caution/Monitor.albuterolmidazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilmidazolam and alfentanil both increase sedation. Use Caution/Monitor.alprazolamalprazolam and midazolam both increase sedation. Use Caution/Monitor.amisulprideamisulpride and midazolam both increase sedation. Use Caution/Monitor.amitriptylinemidazolam and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalamobarbital will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amobarbital and midazolam both increase sedation. Use Caution/Monitor.amoxapinemidazolam and amoxapine both increase sedation. Use Caution/Monitor.apomorphinemidazolam and apomorphine both increase sedation. Use Caution/Monitor.aprepitantaprepitant will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.arformoterolmidazolam increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.aripiprazolemidazolam and aripiprazole both increase sedation. Use Caution/Monitor.armodafinilarmodafinil will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.midazolam increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.artemether/lumefantrineartemether/lumefantrine will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.asenapineasenapine and midazolam both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and midazolam both increase sedation. Use Caution/Monitor.atazanaviratazanavir will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atogepantmidazolam will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.avapritinibmidazolam will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.avapritinib and midazolam both increase sedation. Use Caution/Monitor.axitinibmidazolam increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.azelastineazelastine and midazolam both increase sedation. Use Caution/Monitor.baclofenmidazolam and baclofen both increase sedation. Use Caution/Monitor.belladonna and opiummidazolam and belladonna and opium both increase sedation. Use Caution/Monitor.benperidolmidazolam and benperidol both increase sedation. Use Caution/Monitor.benzphetaminemidazolam increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.berotralstatberotralstat will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor or titrate substrate dose when berotralstat is coadministered with narrow therapeutic index drugs that are CYP3A substrates.bosentanbosentan will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.brexanolonebrexanolone, midazolam. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazolebrexpiprazole and midazolam both increase sedation. Use Caution/Monitor.brimonidinebrimonidine and midazolam both increase sedation. Use Caution/Monitor.brivaracetambrivaracetam and midazolam both increase sedation. Use Caution/Monitor.brompheniraminebrompheniramine and midazolam both increase sedation. Use Caution/Monitor.budesonidebudesonide will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.buprenorphinemidazolam and buprenorphine both increase sedation. Use Caution/Monitor.buprenorphine buccalmidazolam and buprenorphine buccal both increase sedation. Use Caution/Monitor.buprenorphine subdermal implantmidazolam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. In many, but not all of these cases, buprenorphine was misused by self-injection. If a benzodiazepine must be used for an indication other than seizures, lower the benzodiazepine initial dose and cautiously titrate to clinical response.buprenorphine, long-acting injectionmidazolam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.butabarbitalbutabarbital will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.butabarbital and midazolam both increase sedation. Use Caution/Monitor.butalbitalbutalbital will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.butalbital and midazolam both increase sedation. Use Caution/Monitor.butorphanolmidazolam and butorphanol both increase sedation. Use Caution/Monitor.caffeinemidazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbinoxaminecarbinoxamine and midazolam both increase sedation. Use Caution/Monitor.carisoprodolmidazolam and carisoprodol both increase sedation. Use Caution/Monitor.cenobamatecenobamate will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.ceritinibceritinib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.chloral hydratemidazolam and chloral hydrate both increase sedation. Use Caution/Monitor.chloramphenicolchloramphenicol will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of strong CYP3A4 inhibitors with midazolam intranasal causes higher midazolam systemic exposure, which may prolong sedation.chlordiazepoxidechlordiazepoxide and midazolam both increase sedation. Use Caution/Monitor.chlorpheniraminechlorpheniramine and midazolam both increase sedation. Use Caution/Monitor.chlorpromazinemidazolam and chlorpromazine both increase sedation. Use Caution/Monitor.chlorzoxazonemidazolam and chlorzoxazone both increase sedation. Use Caution/Monitor.cholic acidmidazolam increases toxicity of cholic acid by decreasing elimination. Modify Therapy/Monitor Closely. Avoid concomitant use of inhibitors of the bile salt efflux pump (BSEP). May exacerbate accumulation of conjugated bile salts in the liver and result in clinical symptoms. If concomitant use is necessary, monitor serum transaminases and bilirubin.cinnarizinecinnarizine and midazolam both increase sedation. Use Caution/Monitor.clemastineclemastine and midazolam both increase sedation. Use Caution/Monitor.clomipraminemidazolam and clomipramine both increase sedation. Use Caution/Monitor.clonazepamclonazepam and midazolam both increase sedation. Use Caution/Monitor.clorazepateclorazepate and midazolam both increase sedation. Use Caution/Monitor.clozapinemidazolam and clozapine both increase sedation. Use Caution/Monitor.codeinemidazolam and codeine both increase sedation. Use Caution/Monitor.conivaptanconivaptan will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cortisonecortisone will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.crizotinibcrizotinib increases levels of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of crizotinib with CYP3A substrates with narrow therapeutic indices should be avoided.crofelemercrofelemer increases levels of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.cyclizinecyclizine and midazolam both increase sedation. Use Caution/Monitor.cyclobenzaprinemidazolam and cyclobenzaprine both increase sedation. Use Caution/Monitor.cyproheptadinecyproheptadine and midazolam both increase sedation. Use Caution/Monitor.dabrafenibdabrafenib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.dantrolenemidazolam and dantrolene both increase sedation. Use Caution/Monitor.daridorexantmidazolam and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacindarifenacin will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dasatinibdasatinib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.deferasiroxdeferasirox will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.desfluranedesflurane and midazolam both increase sedation. Use Caution/Monitor.desipraminemidazolam and desipramine both increase sedation. Use Caution/Monitor.deutetrabenazinemidazolam and deutetrabenazine both increase sedation. Use Caution/Monitor.dexamethasonedexamethasone will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dexchlorpheniraminedexchlorpheniramine and midazolam both increase sedation. Use Caution/Monitor.dexfenfluraminemidazolam increases and dexfenfluramine decreases sedation. Effect of interaction