Azole Antifungal and Midazolam: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Azole Antifungal and Midazolam unless specifically directed by your doctor.
How Azole Antifungal interacts with Midazolam
Itraconazole, ketoconazole, and voriconazole are potent CYP3A4 inhibitors that block midazolam metabolism, increasing oral midazolam AUC up to 10-15 fold with prolonged and profound sedation.
What you should do
Avoid oral midazolam with strong CYP3A4 inhibitors. If parenteral midazolam is essential, reduce dose by 50-75% and monitor respiratory function.
Key facts
Severity
Major — avoid combination
Mechanism
Itraconazole, ketoconazole, and voriconazole are potent CYP3A4 inhibitors that block midazolam metabolism, increasing or...
Action
Avoid oral midazolam with strong CYP3A4 inhibitors. If parenteral midazolam is essential, reduce dose by 50-75% and moni...
Frequently asked questions
Can I take Azole Antifungal and Midazolam together?
No — this combination should generally be avoided. Avoid oral midazolam with strong CYP3A4 inhibitors. If parenteral midazolam is essential, reduce dose by 50-75% and monitor respiratory function.
What is the severity of this interaction?
The interaction between Azole Antifungal and Midazolam is classified as Major — avoid combination. Itraconazole, ketoconazole, and voriconazole are potent CYP3A4 inhibitors that block midazolam metabolism, increasing oral midazolam AUC up to 10-15 fold with prolonged and profound sedation.
What should I do if I'm prescribed both?
Avoid oral midazolam with strong CYP3A4 inhibitors. If parenteral midazolam is essential, reduce dose by 50-75% and monitor respiratory function. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.