Buspirone with Midazolam Interaction Details
Brand Names Associated with Buspirone
- BuSpar®
- Buspirone
Brand Names Associated with Midazolam
- Midazolam
- Versed®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 06, 2024
Interaction Effect
Increased risk of hypoventilation, airway obstruction, desaturation, or apnea
Interaction Summary
Concomitant use of midazolam with other central nervous system depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect. Anticipated effects range from mild sedation to deep levels of sedation equivalent to a state of general anesthesia where the patient may require external support of vital functions. Monitor closely and be prepared to manage serious cardiorespiratory adverse reactions, including airway management[1].
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of midazolam with other central nervous system depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect. Anticipated effects range from mild sedation to deep levels of sedation equivalent to a state of general anesthesia where the patient may require external support of vital functions. Monitor closely and be prepared to manage serious cardiorespiratory adverse reactions, including airway management[1].
Mechanism Of Interaction
Additive CNS depression
Literature Reports
A) Concomitant administration of IV midazolam and thiopental resulted in synergistic (supraadditive) effects during induction of anesthesia [2]. The combination of IV thiopental and midazolam had 1.8 times the expected potency of the individual drugs, and the dose of thiopental required to produce anesthesia was reduced by 50% in another study [3]. A 15% reduction in the thiopental induction dose requirement has been observed if it follows IM premedication with midazolam [4]. The interaction between midazolam and thiopental may in part be dependent on thiopental dosing [5].
References
1 ) Product Information: SEIZALAM(TM) intramuscular injection, midazolam HCl intramuscular injection. Meridian Medical Technologies, Inc (per DailyMed), Columbia, MD, 2018.
2 ) Tverskoy M, Fleyshman G, Bradley EL, et al: Midazolam-thiopental anesthetic interaction in patients. Anesth Analg 1988; 67:342-345.
3 ) Short TG, Galletly DC, & Plummer JL: Hypnotic and anaesthetic action of thiopentone and midazolam alone and in combination. Br J Anaesth 1991; 66:13-19.
4 ) Product Information: Versed(R), midazolam. Roche Laboratories Inc., Nutley, NJ, 2000.
5 ) Wilder-Smith OHG, Ravussin PA, Decosterd LA, et al: Hypnotic and anaesthetic action of thiopentone and midazolam alone and in combination. Br J Anaesth 1999; 83:590-595.
Buspirone Overview
-
Buspirone is used to treat anxiety disorders or in the short-term treatment of symptoms of anxiety. Buspirone is in a class of medications called anxiolytics. It works by changing the amounts of certain natural substances in the brain.
Midazolam Overview
-
Midazolam is given to children before medical procedures or before anesthesia for surgery to cause drowsiness, relieve anxiety, and prevent any memory of the event. Midazolam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow relaxation and sleep.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.