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