increase sedation. Use Caution/Monitor.cyclophosphamideMinor (1)cyclophosphamide will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyclosporineSerious - Use Alternative (1)cyclosporine will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.cyproheptadineMonitor Closely (1)cyproheptadine and midazolam both increase sedation. Use Caution/Monitor.dabrafenibMonitor Closely (1)dabrafenib will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.dantroleneMonitor Closely (1)midazolam and dantrolene both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)midazolam 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. darifenacinMonitor Closely (1)darifenacin will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.darunavirSerious - Use Alternative (1)darunavir will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Triazolam and midazolam (PO) are extensively metabolized by CYP3A. Coadministration of triazolam or midazolam (PO) with darunavir/ritonavir may cause large increases in the concentrations of these benzodiazepines. Potential for serious and/or life-threatening events (eg, prolonged or increased sedation or respiratory depression)dasatinibMonitor Closely (1)dasatinib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.deferasiroxMonitor Closely (1)deferasirox will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.desfluraneMonitor Closely (1)desflurane and midazolam both increase sedation. Use Caution/Monitor.desipramineMonitor Closely (1)midazolam and desipramine both increase sedation. Use Caution/Monitor.deutetrabenazineMonitor Closely (1)midazolam and deutetrabenazine both increase sedation. Use Caution/Monitor.dexamethasoneMonitor Closely (1)dexamethasone will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and midazolam both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)midazolam increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)midazolam and dexmedetomidine both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)midazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)midazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextromoramideMonitor Closely (1)midazolam and dextromoramide both increase sedation. Use Caution/Monitor.DHEA, herbalMonitor Closely (1)DHEA, herbal will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.diamorphineMonitor Closely (1)midazolam and diamorphine both increase sedation. Use Caution/Monitor.diazepamMonitor Closely (1)diazepam and midazolam both increase sedation. Use Caution/Monitor.diazepam intranasalMonitor Closely (1)diazepam intranasal, midazolam. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.diethylpropionMonitor Closely (1)midazolam increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.difelikefalinMonitor Closely (1)difelikefalin and midazolam both increase sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)midazolam and difenoxin hcl both increase sedation. Use Caution/Monitor.diltiazemMonitor Closely (1)diltiazem will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Midazolam dose adjustments may be necessary in patients receiving concomitant diltiazem and midazolam. Monitor for signs of midazolam toxicity (eg, sedation, somnolence, confusion, impaired coordination, diminished reflexes, coma).dimenhydrinateMonitor Closely (1)dimenhydrinate and midazolam both increase sedation. Use Caution/Monitor.diphenhydramineMonitor Closely (1)diphenhydramine and midazolam both increase sedation. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)midazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.dipipanoneMonitor Closely (1)midazolam and dipipanone both increase sedation. Use Caution/Monitor.dobutamineMonitor Closely (1)midazolam increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dopamineMonitor Closely (1)midazolam increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dopexamineMonitor Closely (1)midazolam increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dosulepinMonitor Closely (1)midazolam and dosulepin both increase sedation. Use Caution/Monitor.doxepinMonitor Closely (1)midazolam and doxepin both increase sedation. Use Caution/Monitor.doxylamineMonitor Closely (1)midazolam and doxylamine both increase sedation. Use Caution/Monitor.dronedaroneMonitor Closely (1)dronedarone will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.droperidolMonitor Closely (1)midazolam and droperidol both increase sedation. Use Caution/Monitor.duvelisibMonitor Closely (1)duvelisib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.efavirenzMonitor Closely (1)efavirenz will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.elagolixMonitor Closely (1)elagolix decreases levels of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing oral midazolam dose if needed.eluxadolineMonitor Closely (1)eluxadoline increases levels of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution when CYP3A substrates that have a narrow therapeutic index are coadministered with eluxadoline.elvitegravir/cobicistat/emtricitabine/tenofovir DFContraindicated (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events; contraindication applies to oral midazolam; consider dose reduction for parenteral midazolam.encorafenibMonitor Closely (1)encorafenib, midazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.enzalutamideSerious - Use Alternative (1)enzalutamide will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.epcoritamabMonitor Closely (1)epcoritamab, midazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Epcoritamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .ephedrineMonitor Closely (1)midazolam increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrineMonitor Closely (1)midazolam increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrine racemicMonitor Closely (1)midazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.erdafitinibSerious - Use Alternative (1)erdafitinib, midazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with erdafitinib and sensitive CYP3A4 substrates with narrow therapeutic indices. Erdafitinib may altered plasma concentrations of CYP3A4 substrates, leading to either loss of activity or increased toxicity of the substrate.erythromycin baseSerious - Use Alternative (1)erythromycin base will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin ethylsuccinateSerious - Use Alternative (1)erythromycin ethylsuccinate will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin lactobionateSerious - Use Alternative (1)erythromycin lactobionate will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin stearateSerious - Use Alternative (1)erythromycin stearate will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.esketamine intranasalMonitor Closely (1)esketamine intranasal, midazolam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.esomeprazoleMinor (1)esomeprazole increases levels of midazolam by decreasing metabolism. Minor/Significance Unknown.estazolamMonitor Closely (1)estazolam and midazolam both increase sedation. Use Caution/Monitor.ethanolMonitor Closely (1)midazolam and ethanol both increase sedation. Use Caution/Monitor.ethinylestradiolMonitor Closely (1)ethinylestradiol will increase the level or effect of midazolam by Mechanism: decreasing metabolism. Use Caution/Monitor. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.etomidateMonitor Closely (1)etomidate and midazolam both increase sedation. Use Caution/Monitor.etravirineMonitor Closely (1)etravirine will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.eucalyptusMinor (1)midazolam and eucalyptus both increase sedation. Minor/Significance Unknown.fedratinibMonitor Closely (1)fedratinib will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.fenfluramineMonitor Closely (1)midazolam increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fexinidazoleSerious - Use Alternative (1)fexinidazole will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.finerenoneMonitor Closely (1)midazolam will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.fleroxacinMinor (1)fleroxacin increases levels of midazolam by decreasing metabolism. Minor/Significance Unknown.flibanserinMonitor Closely (2)midazolam will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors. midazolam and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.fluconazoleMonitor Closely (1)fluconazole will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fludrocortisoneMonitor Closely (1)fludrocortisone will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fluphenazineMonitor Closely (1)midazolam and fluphenazine both increase sedation. Use Caution/Monitor.flurazepamMonitor Closely (1)flurazepam and midazolam both increase sedation. Use Caution/Monitor.fluvoxamineMonitor Closely (1)fluvoxamine will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May increase risk of hypoventilation, airway obstruction, or apnea and may contribute to profound and/or prolonged drug effectformoterolMonitor Closely (1)midazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fosamprenavirMonitor Closely (1)fosamprenavir will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fosamprenavir increases levels of midazolam by decreasing metabolism. Contraindicated.fosaprepitantMonitor Closely (1)fosaprepitant will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fosphenytoinMonitor Closely (1)fosphenytoin will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.gabapentinMonitor Closely (1)gabapentin, midazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.gabapentin enacarbilMonitor Closely (1)gabapentin enacarbil, midazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.ganaxoloneMonitor Closely (1)midazolam and ganaxolone both increase sedation. Use Caution/Monitor.gemifloxacinMinor (1)gemifloxacin increases levels of midazolam by decreasing metabolism. Minor/Significance Unknown.glofitamabMonitor Closely (1)glofitamab, midazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Glofitamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .glycerol phenylbutyrateMonitor Closely (1)glycerol phenylbutyrate will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Glycerol phenylbutyrate is a weak inducer of CYP3A4. Monitor for decreased efficacy of CYP3A4 substrates that have a narrow therapeutic index. Cmax and AUC were 25% and 32% lower for a single dose of midazolam after multiple doses of glycerol phenylbutyrate.grapefruitMonitor Closely (1)grapefruit will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.green teaMinor (1)green tea decreases effects of midazolam by pharmacodynamic antagonism. Minor/Significance Unknown. Caffeine component of green tea may decrease sedative effects of benzodiazepines.griseofulvinMonitor Closely (1)griseofulvin will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.guselkumabMonitor Closely (1)guselkumab, midazolam. Other (see comment). Use Caution/Monitor. Comment: Formation of CYP450 enzymes can be altered by increased levels of certain cytokines during chronic inflammation; thus, normalizing the formation of CYP450 enzymes. Upon initiation or discontinuation of guselkumab in patients who are receiving concomitant CYP450 substrates, particularly those with a narrow therapeutic index, consider monitoring for therapeutic effect.haloperidolMonitor Closely (1)midazolam and haloperidol both increase sedation. Use Caution/Monitor.hydrocodoneSerious - Use Alternative (1)hydrocodone, midazolam. Either increases toxicity 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.hydrocortisoneMonitor Closely (1)hydrocortisone will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4