Midazolam Injection and Boceprevir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Boceprevir
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
Increased midazolam concentrations
Interaction Deep Dive
Boceprevir is a strong inhibitor of CYP3A4/5 isozymes. Concomitant use of boceprevir and oral midazolam (a CYP3A4 substrate) resulted in significant increases in midazolam exposure and plasma concentration in a pharmacokinetic study. Due to the potential for serious midazolam adverse effects including increased or prolonged sedation, or respiratory depression, concomitant use of boceprevir and orally administered midazolam is contraindicated. If concomitant use with IV midazolam is necessary, a lower dose of IV midazolam should be considered and close clinical monitoring for respiratory depression and/or prolonged sedation is recommended1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) In a pharmacokinetic study in healthy subjects or hepatitis C virus-positive (genotype-1) patients, concomitant administration of boceprevir 800 mg 3 times daily for 6 days and a single 4 mg oral dose of midazolam resulted in substantial increases in boceprevir AUC and Cmax. The ratio of boceprevir mean Cmax and AUC (with midazolam to without midazolam) was 2.77 (90% confidence interval (CI), 2.36 to 3.25) and 5.3 (90% CI, 4.66 to 6.03), respectively 1.
Common questions
Can I take Midazolam Injection and Boceprevir together?
Increased midazolam concentrations Always confirm with your pharmacist or prescriber before making any change.
How serious is the Midazolam Injection and Boceprevir interaction?
It is rated contraindicated. These should generally not be used together.
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 Midazolam Injection or Boceprevir 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: VICTRELIS(TM) oral capsules, boceprevir oral capsules. Merck & Co, Inc, Whitehouse Station, NJ, 2011.
Keep reading about Boceprevir
Keep reading about Midazolam Injection
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