Laropiprant and Midazolam Nasal Spray: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Midazolam Nasal Spray
Laropiprant
No brand names on record
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 exposure of active metabolite of midazolam
Interaction Deep Dive
The concomitant use of midazolam, which has an active metabolite (1'-hydroxymidazolam) that is a uridine diphosphate-glucuronosyltransferase (UGT)2B4 and UGT2B7 substrate, and laropiprant, a mild-to-moderate inhibitor of UGT2B4 and UGT2B7, may increase the exposure of the midazolam active metabolite. Coadministration of laropiprant 40 mg and midazolam increased the AUC of 1'-hydroxymidazolam by 98% and the Cmax of the metabolite by 59%. Use caution with coadministration of drugs containing laropiprant and midazolam, as the sedative effect of midazolam may be increased12.
Why it happens (mechanism)
Inhibition of uridine diphosphate-glucuronosyltransferase (UGT)2B4 and UGT2B7-mediated metabolism of midazolam active metabolite
Common questions
Can I take Laropiprant and Midazolam Nasal Spray together?
Increased exposure of active metabolite of midazolam Always confirm with your pharmacist or prescriber before making any change.
How serious is the Laropiprant and Midazolam Nasal Spray interaction?
It is rated moderate. Can be significant — usually manageable with 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 Laropiprant or Midazolam Nasal Spray 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 (2)
- Product Information: Pelzont oral extended-release tablets, laropiprant nicotinic acid oral extended-release tablets. Merck Sharp & Dohme Ltd. (per EMA), Hoddesdon, Hertfordshire, United Kingdom, 2012.
- Product Information: Trevaclyn oral extended-release tablets, laropiprant nicotinic acid oral extended-release tablets. Merck Sharp & Dohme Ltd. (per EMA), Hoddesdon, Hertfordshire, United Kingdom, 2012.
Keep reading about Midazolam Nasal Spray
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