diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.lasmiditanMonitor Closely (1)lasmiditan, diazepam. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.lemborexantMonitor Closely (2)diazepam will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification. lemborexant, diazepam. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.lenacapavirMonitor Closely (1)lenacapavir will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates. levoketoconazoleSerious - Use Alternative (1)levoketoconazole will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.levonorgestrel oral/ethinylestradiol/ferrous bisglycinateMonitor Closely (1)levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will increase the level or effect of diazepam by decreasing metabolism. Use Caution/Monitor. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.levorphanolMonitor Closely (1)diazepam and levorphanol both increase sedation. Use Caution/Monitor.lofepramineMonitor Closely (1)diazepam and lofepramine both increase sedation. Use Caution/Monitor.lofexidineMonitor Closely (1)diazepam and lofexidine both increase sedation. Use Caution/Monitor.lomitapideMonitor Closely (1)diazepam increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.lonafarnibSerious - Use Alternative (2)diazepam will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown. lonafarnib will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Lonafarnib may increase the AUC and peak concentration of CYP2C19 substrates. If coadministration unavoidable, monitor for adverse reactions and reduce the CYP2C19 substrate dose in accordance with its approved product labeling.lopinavirMonitor Closely (1)lopinavir increases levels of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available.loprazolamMonitor Closely (1)diazepam and loprazolam both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (1)diazepam and lorazepam both increase sedation. Use Caution/Monitor.lorlatinibMonitor Closely (1)lorlatinib will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lormetazepamMonitor Closely (1)diazepam and lormetazepam both increase sedation. Use Caution/Monitor.loxapineMonitor Closely (1)diazepam and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)diazepam and loxapine inhaled both increase sedation. Use Caution/Monitor.lumacaftor/ivacaftorMonitor Closely (1)lumacaftor/ivacaftor, diazepam. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .lumefantrineMonitor Closely (1)lumefantrine will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lurasidoneMonitor Closely (1)lurasidone, diazepam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilineMonitor Closely (1)diazepam and maprotiline both increase sedation. Use Caution/Monitor.marijuanaMonitor Closely (2)marijuana will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. diazepam and marijuana both increase sedation. Use Caution/Monitor.mavacamtenMonitor Closely (1)diazepam will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. melatoninMonitor Closely (1)diazepam and melatonin both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (1)diazepam and meperidine both increase sedation. Use Caution/Monitor.meprobamateMonitor Closely (1)diazepam and meprobamate both increase sedation. Use Caution/Monitor.metaxaloneMonitor Closely (1)diazepam and metaxalone both increase sedation. Use Caution/Monitor.methadoneMonitor Closely (1)diazepam and methadone both increase sedation. Use Caution/Monitor.methamphetamineMonitor Closely (1)diazepam increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methocarbamolMonitor Closely (1)diazepam and methocarbamol both increase sedation. Use Caution/Monitor.methylenedioxymethamphetamineMonitor Closely (1)diazepam increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methylphenidate transdermalMonitor Closely (1)methylphenidate transdermal will increase the level or effect of diazepam by decreasing metabolism. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. methylprednisoloneMonitor Closely (1)methylprednisolone will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.metoclopramide intranasalSerious - Use Alternative (1)diazepam, 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.metoprololMinor (1)metoprolol increases effects of diazepam by decreasing metabolism. Minor/Significance Unknown.metronidazoleMonitor Closely (1)metronidazole will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.miconazole vaginalMonitor Closely (1)miconazole vaginal will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.midazolamMonitor Closely (1)diazepam and midazolam both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (2)diazepam will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation. midazolam intranasal, diazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midodrineMonitor Closely (1)diazepam increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mifepristoneSerious - Use Alternative (1)mifepristone will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.mirtazapineMonitor Closely (1)diazepam and mirtazapine both increase sedation. Use Caution/Monitor.mitotaneMonitor Closely (1)mitotane decreases levels of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.modafinilMinor (1)modafinil will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.morphineMonitor Closely (1)diazepam and morphine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)diazepam and motherwort both increase sedation. Use Caution/Monitor.moxonidineMonitor Closely (1)diazepam and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)diazepam and nabilone both increase sedation. Use Caution/Monitor.nalbuphineMonitor Closely (1)diazepam and nalbuphine both increase sedation. Use Caution/Monitor.nefazodoneSerious - Use Alternative (1)nefazodone will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.nelfinavirMonitor Closely (1)nelfinavir increases levels of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available.nevirapineMonitor Closely (1)nevirapine will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nifedipineMonitor Closely (1)nifedipine will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nilotinibMonitor Closely (1)nilotinib will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nortriptylineMonitor Closely (1)diazepam and nortriptyline both increase sedation. Use Caution/Monitor.olanzapineMonitor Closely (1)diazepam and olanzapine both increase sedation. Use Caution/Monitor.oliceridineMonitor Closely (2)oliceridine, diazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. 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. diazepam increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.olopatadine intranasalSerious - Use Alternative (1)diazepam 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. ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)Monitor Closely (1)ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) decreases effects of diazepam by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Increase dose if clinically indicated.omeprazoleMinor (1)omeprazole will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.onabotulinumtoxinAMinor (1)diazepam decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.opium tinctureMonitor Closely (1)diazepam and opium tincture both increase sedation. Use Caution/Monitor.orlistatMonitor Closely (1)orlistat decreases levels of diazepam by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Risk of convulsions.orphenadrineMonitor Closely (1)diazepam and orphenadrine both increase sedation. Use Caution/Monitor.oxazepamMonitor Closely (1)diazepam and oxazepam both increase sedation. Use Caution/Monitor.oxcarbazepineMonitor Closely (1)oxcarbazepine will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)oxcarbazepine will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.oxycodoneMonitor Closely (1)diazepam and oxycodone both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)diazepam and oxymorphone both increase sedation. Use Caution/Monitor.paliperidoneMonitor Closely (1)diazepam and paliperidone both increase sedation. Use Caution/Monitor.pancuroniumMinor (1)diazepam decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.papaveretumMonitor Closely (1)diazepam and papaveretum both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)diazepam and papaverine both increase sedation. Use Caution/Monitor.parecoxibMinor (1)parecoxib will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.pentazocineMonitor Closely (1)diazepam and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (2)pentobarbital will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. pentobarbital and diazepam both increase sedation. Use Caution/Monitor.perampanelMonitor Closely (1)perampanel and diazepam both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (1)diazepam and perphenazine both increase sedation. Use Caution/Monitor.phenobarbitalMonitor Closely (2)phenobarbital will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. phenobarbital and diazepam both increase sedation. Use Caution/Monitor.Minor (1)phenobarbital will decrease the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.phenylephrine POMonitor Closely (1)diazepam increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pholcodineMonitor Closely (1)diazepam and pholcodine both increase sedation. Use Caution/Monitor.pimozideMonitor Closely (1)diazepam and pimozide both increase sedation. Use Caution/Monitor.posaconazoleMonitor Closely (1)posaconazole will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.prabotulinumtoxinAMonitor Closely (1)diazepam increases effects of prabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Muscle relaxants may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.prednisoneMonitor Closely (1)prednisone will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, diazepam. 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.primidoneMonitor Closely (2)primidone will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. primidone and diazepam both increase sedation. Use Caution/Monitor.Minor (1)primidone will decrease the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.prochlorperazineMonitor Closely (1)diazepam and prochlorperazine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine and diazepam both increase sedation. Use Caution/Monitor.propofolMonitor Closely (1)propofol and diazepam both increase sedation. Use Caution/Monitor.propranololMinor (1)propranolol increases effects of diazepam by decreasing metabolism. Minor/Significance Unknown.propylhexedrineMonitor Closely (1)diazepam increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (1)diazepam and protriptyline both increase sedation. Use Caution/Monitor.quazepamMonitor Closely (1)diazepam and quazepam both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (1)diazepam and quetiapine both increase sedation. Use Caution/Monitor.quinupristin/dalfopristinMonitor Closely (1)quinupristin/dalfopristin will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ramelteonMonitor Closely (1)diazepam and ramelteon both increase sedation. Use Caution/Monitor.rapacuroniumMinor (1)diazepam decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.remimazolamMonitor Closely (1)remimazolam, diazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutinSerious - Use Alternative (1)rifabutin will decrease