Ivacaftor and Midazolam Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ivacaftor
Midazolam 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
Increased benzodiazepine exposure and an increased risk of benzodiazepine-related adverse effects
Interaction Deep Dive
The concomitant administration of ivacaftor, a CYP3A inhibitor, with midazolam, a benzodiazepine and also a CYP3A4 substrate, increased midazolam AUC by 1.5-fold. A similar reaction can be expected with other benzodiazepines. Use caution if ivacaftor and a benzodiazepine are coadministered as this may result in increased benzodiazepine exposure and may cause benzodiazepine-related adverse effects. Monitor for benzodiazepine-related side effects1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism by ivacaftor
Literature reports
1 report — tap to read
a) Coadministration of ivacaftor with midazolam (a sensitive CYP3A substrate and a benzodiazepine) increased the midazolam exposure by 1.5-fold 1.
Common questions
Can I take Ivacaftor and Midazolam Injection together?
Increased benzodiazepine exposure and an increased risk of benzodiazepine-related adverse effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ivacaftor and Midazolam Injection 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 "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Ivacaftor 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 a safer alternative to one of these medications for me?
References (1)
- Product Information: KALYDECO(R) oral tablets, oral granules, ivacaftor oral tablets, oral granules. Vertex Pharmaceuticals Incorporated (per FDA), Boston, MA, 2023. DailyMed
Keep reading about Ivacaftor
Keep reading about Midazolam Injection
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