Fluvoxamine and Midazolam Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Fluvoxamine
No brand names on recordMidazolam Injection
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
Elevated serum midazolam concentrations
Interaction Deep Dive
Fluvoxamine coadministration (100 mg daily) with alprazolam 1 mg four times daily resulted in a 2-fold increase in alprazolam steady-state plasma concentrations, AUC, Cmax, and half-life. Elevated plasma levels of alprazolam were associated with impaired psychomotor performance and memory. This suggests that fluvoxamine is a potent inhibitor of cytochrome P450 3A4 enzymes, which are responsible for alprazolam metabolism. Because midazolam also relies on CYP3A4 for metabolism, a similar interaction with fluvoxamine seems likely1.
Why it happens (mechanism)
Inhibition of midazolam metabolism due to cytochrome P450 3A4 enzyme inhibition
Common questions
Can I take Fluvoxamine and Midazolam Injection together?
Elevated serum midazolam concentrations Always confirm with your pharmacist or prescriber before making any change.
How serious is the Fluvoxamine and Midazolam Injection interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Fluvoxamine or Midazolam Injection 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 anything you'd monitor while I'm on both?
References (1)
- Product Information: Luvox(R), fluvoxamine. Solvay Pharmaceuticals, Inc. Marietta, GA, 1997. DailyMed
Keep reading about Fluvoxamine
Keep reading about Midazolam Injection
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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