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Does Midazolam Interact with Ramelteon?

Midazolam and Ramelteon have a unknown drug interaction according to U.S. FDA drug labeling data. Concomitant administration of ramelteon with omeprazole (CYP2C19 substrate), dextromethorphan (CYP2D6 substrate), midazolam (CYP3A4 substrate), theophylline (CYP1A2 substrate), digoxin (p-glycoprotein substrate), warfarin (CYP2C9 [S]/CYP1A2 [R] substrate), venlafaxine, fluvoxamine, donepezil, doxepin, sertraline, escitalopram, and gabapentin did not produce clinically meaningful changes in peak and total exposures to these drugs. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.

Severity
Unknown
Midazolam Class
Benzodiazepine
Ramelteon Class
Melatonin Receptor Agonist
Management
Consult your pharmacist
Data Source
U.S. FDA via OpenFDA

What To Tell Your Doctor or Pharmacist

If you are taking Midazolam and your doctor is considering prescribing Ramelteon (or vice versa), make sure to:

  • Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
  • Ask whether the benefits of combining these medications outweigh the risks for your specific situation
  • Ask what symptoms to watch for that would indicate the interaction is causing problems
  • Never stop or change either medication without first consulting your healthcare provider
💊 Midazolam(Nayzilam)+💊 Ramelteon(Rozerem)

Severity & Interaction Details

ℹ️
unknown
Interaction documented — severity unclassified
The FDA label notes an interaction but the severity is not classified in our dataset.
Severity scale
MinorContra
On record
Yes
Drug A class
Benzodiazepine
Drug B class
Melatonin Receptor Agonist
Source
FDA drug label - ramelteon

What this means in plain English

Concomitant administration of ramelteon with omeprazole (CYP2C19 substrate), dextromethorphan (CYP2D6 substrate), midazolam (CYP3A4 substrate), theophylline (CYP1A2 substrate), digoxin (p-glycoprotein substrate), warfarin (CYP2C9 [S]/CYP1A2 [R] substrate), venlafaxine, fluvoxamine, donepezil, doxepin, sertraline, escitalopram, and gabapentin did not produce clinically meaningful changes in peak and total exposures to these drugs.

About Midazolam and Ramelteon

Midazolam is a Benzodiazepine, while Ramelteon is a Melatonin Receptor Agonist. You may recognize them by the brand names Nayzilam and Rozerem. Midazolam is given by intravenous (IV) infusion, whereas Ramelteon is taken by mouth. Midazolam additionally carries an FDA boxed warning, the FDA's strongest safety alert.

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Data integrity: Every interaction shown is extracted directly from official U.S. FDA drug labeling via openFDA and the U.S. National Library of Medicine (NIH) — no interactions are invented, inferred, or manually edited. Maintained by CheckDrugInteractions.com. See our methodology or report a correction at support@checkdruginteractions.com.

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine, supplemented with a small number of well-established interactions from curated clinical references. For informational purposes only. Always consult your pharmacist or physician.