Drug Interaction Report

Midazolam Injection and Tranylcypromine: Interaction Details

A pharmacist-reviewed analysis of the Midazolam Injection and Tranylcypromine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Tranylcypromine

Parnate
+

Midazolam Injection

Nayzilam Versed® Injection
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 276 documented Midazolam Injection interactions, 197 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased risk of CNS depression

Interaction Deep Dive

Exert caution when tranylcypromine is coadministered with CNS depressants as it may increase the risk of CNS depression1.

Why it happens (mechanism)

Additive CNS depression

Literature reports

1 report — tap to read

a) Concurrent use of monoamine oxidase (MAO) inhibitors with central nervous system (CNS) depressants, including barbiturates, may result in hypotension and exaggeration of the CNS and respiratory depressant effects 23. The mechanism of action for this potentiation is not completely known; however, it is felt that MAO inhibitors may also block enzymes that are needed for the inactivation of metabolites of other drugs 4.

Common questions

Can I take Midazolam Injection and Tranylcypromine together?

An increased risk of CNS depression Always confirm with your pharmacist or prescriber before making any change.

How serious is the Midazolam Injection and Tranylcypromine 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Midazolam Injection or Tranylcypromine 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 (4)

  1. Product Information: Tranylcypromine oral tablets, tranylcypromine oral tablets. Solco Healthcare US, LLC (per DailyMed), Somerset, NJ, 2024. DailyMed
  2. Elis J, Laurence DR, Mattie H, et al: Modification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure. Br Med J 1967; 2:75-78. PubMed
  3. Sjoqvist F: Psychotropic drugs (2). Interaction between monoamine oxidase (MAO) inhibitors and other substances. Proc R Soc Med 1965; 58:967-978. DOI
  4. Kato R, Chiesara E, & Vassanelli P: Further studies on inhibition and stimulation of microsomal drug metabolizing enzymes of rat liver by various compounds. Biochem Pharmacol 1964; 13:69-83.
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Tranylcypromine

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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Tranylcypromine + Activated Charcoal Beer Bitter Orange Brewer's Yeast Cowhage Fever Bark Lithium Rauvolfia Vomitoria + 73 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.