Midazolam drug interactions should be taken into account before administering this medication.
The hypnotic effect of IV Midazolam and the risk of apnoea are accentuated by premedication, particularly narcotics (e.g., morphine, meperidine and fentanyl), secobarbital, and the droperidol-fentanyl combination.
Consequently, the midazolam drug interactions should be adjusted according to the type and amount of premedication administered.
A slight reduction in induction dosage requirements of thiopental (about 13%) has been noted following IM use of midazolam for premedication. The administration of midazolam has resulted in a dose-dependent reduction of the minimum alveolar concentration of halothane required during maintenance of anesthesia.
Preliminary data, with a small number of subjects, reveal that midazolam appears to potentiate the effect of pancuronium.
Midazolam injection does not cause a clinically significant change in onset or duration of action of a single intubating dose of succinylcholine.
Midazolam drug interactions does not protect against the characteristic circulatory changes noted after administration of succinylcholine or pancuronium.
Data from spontaneous reports as well as kinetic studies in humans indicate that midazolam drug interactions with compounds which affect are also metabolized by the cytochrome P450 3A4 hepatic enzymes.
Data of midazolam drug interactions indicate that these compounds (cimetidine, erythromycin, diltiazem, verapamil, ketoconazole and itraconazole) influence the pharmacokinetics of midazolam (increased Cmax and AUC) and may lead to prolonged sedation.
Therefore, patients receiving the above compounds or others which inhibit P450 3A4 enzymes together with midazolam should be monitored for the first few hours after administration of midazolam drug interactions .