Midazolam and Posaconazole interaction
Midazolam and Posaconazole: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.
Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.
What the FDA labels say
From the Midazolam (Midazolam in Sodium Chloride) label · effective 2025-07-31
Cytochrome P450-3A4 Inhibitors : May result in prolonged sedation due to decreased plasma clearance of midazolam.
Cytochrome P450-3A4 Inhibitors Concomitant administration with drugs that are known to inhibit the P450-3A4 enzyme system, such as cimetidine (not ranitidine), erythromycin, diltiazem, verapamil, ketoconazole and itraconazole, may result in prolonged sedation due to a decrease in plasma clearance of midazolam.
From the Posaconazole (NOXAFIL) label · effective 2026-02-13
Concomitant Use with Midazolam : Noxafil can prolong hypnotic/sedative effects.
Midazolam Toxicity Concomitant administration of Noxafil with midazolam increases the midazolam plasma concentrations by approximately 5-fold.
Increased plasma midazolam concentrations could potentiate and prolong hypnotic and sedative effects.
Monitor patients and benzodiazepine receptor antagonists should be available.
Patients must be monitored closely for adverse effects associated with high plasma concentrations of midazolam and benzodiazepine receptor antagonists must be available to reverse these effects [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] .
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.