Asenapine Transdermal Patch and Remimazolam: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Remimazolam
Asenapine Transdermal Patch
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of profound sedation, respiratory depression, coma, and death
Interaction Deep Dive
Concomitant use of remimazolam and opioid analgesics may result in profound sedation, respiratory depression, coma, and death. The sedative effect of IV remimazolam can be accentuated by concomitantly administered CNS depressant medications, including other benzodiazepines and propofol. Continuously monitor patients for respiratory depression and depth of sedation. Titrate the dose of remimazolam when administered with opioid analgesics and sedative-hypnotics to the desired clinical response. Continuously monitor sedated patients for hypotension, airway obstruction, hypoventilation, apnea, and oxygen desaturation. These cardiorespiratory effects may be more likely to occur in patients with obstructive sleep apnea, the elderly, and patients with an American Society of Anesthesiologists Physical Status of 3 or 41.
Why it happens (mechanism)
Additive CNS depression
Common questions
Can I take Asenapine Transdermal Patch and Remimazolam together?
Increased risk of profound sedation, respiratory depression, coma, and death Always confirm with your pharmacist or prescriber before making any change.
How serious is the Asenapine Transdermal Patch and Remimazolam interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Asenapine Transdermal Patch or Remimazolam need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: BYFAVO(TM) intravenous injection, remimazolam intravenous injection. Acacia Pharma Inc (per FDA), Indianapolis, IN, 2020. DailyMed
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