MIDAZOLAM HCL

Midazolam Hydrochloride 2mg/1mL, Oral syrup

Caffeine-containing Foods/Beverages

· Severity: Mild

· Notes for Consumers: If you are taking medicine to help you sleep, avoid taking Caffeine and Caffeine-containing foods or beverages like colas, coffee, teas, or chocolates within several hours prior to bedtime.

· Notes for Professionals: Patients taking benzodiazepines for insomnia should not use caffeine-containing products prior to going to bed as these products may antagonize the sedative effects of the benzodiazepine.

Midazolam Hydrochloride 2mg/1mL, Oral syrup

Alcohol

· Severity: Major

· Notes for Consumers: Avoid alcohol-containing drinks while taking this medicine. Using this drug along with alcohol can lead to serious side effects. You may feel drowsy or more tired when taking these drugs together. Do not drive or operate machinery until you know how this drug affects you, and especially if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: Alcohol is associated with CNS depression. The combined use of alcohol and CNS depressants can lead to additive CNS depression, which could be dangerous in tasks requiring mental alertness and fatal in overdose. Alcohol taken with other CNS depressants can lead to additive respiratory depression, hypotension, profound sedation, or coma. Consider the patient's use of alcohol or illicit drugs when prescribing CNS depressant medications. In many cases, the patient should receive a lower dose of the CNS depressant initially if the patient is not likely to be compliant with avoiding alcohol.

Midazolam Hydrochloride 2mg/1mL, Oral syrup

Marijuana

· Severity: Major

· Notes for Consumers: Avoid combining Benzodiazepines and marijuana. This combination may lead to serious side effects. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: Coadministration of marijuana with benzodiazepines may result in an exaggerated sedative effect. Instruct patients receiving these medications concurrently not to drive or operate machinery.

Midazolam Hydrochloride 2mg/1mL, Oral syrup

Grapefruit juice

· Severity: Severe

· Notes for Consumers: Midazolam is generally only used in a hospital or clinic. Grapefruit juice and Grapefruit-containing foods may increase the actions or side effects (such as drowsiness or slowed breathing) of Midazolam. Avoid Grapefruit juice (or Grapefruit) on the day you receive Midazolam. If you notice slurred speech, confusion, severe weakness, or difficulty breathing after receiving Midazolam in a hospital or clinic, contact your health care provider immediately.

· Notes for Professionals: Clinicians should be aware that grapefruit juice (food) interactions with midazolam are possible. Grapefruit juice inhibits the cytochrome P-450 3A4 isozyme in the gut wall. Grapefruit juice contains furanocoumarins that are metabolized by CYP3A4 to reactive intermediates. These intermediates form a covalent bond to the active site of the CYP3A4 enzyme, causing irreversible inactivation (mechanism-based inhibition). Consequently, CYP3A4 activity in the gut wall is inhibited until de novo synthesis returns the enzyme to its previous level. Grapefruit juice has been shown to increase midazolam peak serum concentrations and AUC by up to 50% when midazolam was administered orally. Increased sedation may be possible. It is recommended that oral midazolam not be taken in conjunction with grapefruit juice. Clinicians should be aware of the possibility of other food interactions (e.g., grapefruit) with orally-administered midazolam.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>