Midazolam/Macrolide Antibiotics Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not properly process midazolam.

What might happen:

Your blood levels of your midazolam may increase and cause excess drowsiness.

What you should do about this interaction:

If you experience severe drowsiness or confusion, contact your doctor. It may be necessary to adjust the dose of your medicine.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Yeates RA, Laufen H, Zimmermann T. Interaction between midazolam and clarithromycin: comparison with azithromycin. Int J Clin Pharmacol Ther 1996 Sep;34(9):400-5.
  • 2.Quinney SK, Haehner BD, Rhoades MB, Lin Z, Gorski JC, Hall SD. Interaction between midazolam and clarithromycin in the elderly. Br J Clin Pharmacol 2008 Jan;65(1):98-109.
  • 3.Olkkola KT, Aranko K, Luurila H, Hiller A, Saarnivaara L, Himberg JJ, Neuvonen PJ. A potentially hazardous interaction between erythromycin and midazolam. Clin Pharmacol Ther 1993 Mar;53(3):298-305.
  • 4.Hiller A, Olkkola KT, Isohanni P, Saarnivaara L. Unconsciousness associated with midazolam and erythromycin. Br J Anaesth 1990 Dec; 65(6):826-8.
  • 5.Wood M. Midazolam and erythromycin. Br J Anaesth 1991 Jul;67(1):131. 6.Backman JT, Aranko K, Himberg JJ, Olkkola KT. A pharmacokinetic interaction between roxithromycin and midazolam. Eur J Clin Pharmacol 1994;46(6):551-5.
  • 6.Ketek (telithromycin) US prescribing information. Sanofi-Aventis U.S. LLC November, 2015.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.