Omeprazole and Triazolam: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Triazolam
Omeprazole
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.
Here's what's going on. Triazolam (Halcion) is a sleep medicine that your body breaks down using a liver enzyme. Omeprazole (Prilosec) can slow that enzyme down, so the triazolam may hang around longer and build up in your system.
In plain terms, that can mean more of the sleepy, groggy effects: extra drowsiness, feeling unsteady on your feet, slower thinking, or trouble with your speech, especially the morning after. This isn't a reason to panic, and please don't stop either medicine on your own. Just let your pharmacist or doctor know you take both. They can adjust your dose or watch you a little more closely, and it's very manageable.
Mechanism: Omeprazole inhibits CYP-mediated (notably CYP3A4/CYP2C19) oxidative metabolism of triazolam, reducing clearance and increasing exposure. Neither drug is a prodrug here, so this increases triazolam effect.
- Effect: Enhanced, prolonged benzodiazepine activity (CNS depression, sedation, ataxia, lethargy).
- Onset: Delayed. Evidence: Probable (extrapolated from documented diazepam-omeprazole data; more pronounced in extensive omeprazole metabolizers).
- Management: Monitor for sedation, lethargy, slurred speech, impaired coordination; individualize/reduce triazolam dose. Consider a glucuronidated benzodiazepine (lorazepam, oxazepam, temazepam) that bypasses CYP metabolism.
What happens
Benzodiazepine toxicity (CNS depression, ataxia, lethargy)
Interaction Deep Dive
Taking diazepam together with omeprazole has been documented to reduce the rate at which diazepam is metabolized and to delay its clearance, which produces stronger and longer-lasting benzodiazepine effects523. In one investigation, reduced diazepam clearance was seen in nearly one half of patients who were rapid metabolizers of omeprazole, whereas the combination carried little clinical relevance in individuals who were slow metabolizers of omeprazole1. Comparable effects would be anticipated with triazolam-omeprazole therapy, though this has not yet been established. Because lorazepam, oxazepam, and temazepam are benzodiazepines cleared through glucuronidation instead of the cytochrome P450 enzyme system, they may serve as suitable alternatives for patients who require both omeprazole and benzodiazepine treatment.
Why it happens (mechanism)
Slowed benzodiazepine metabolism and clearance
How to manage this interaction
The good news is your care team can manage this easily. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Watch for extra drowsiness, grogginess, unsteadiness, or slurred speech, and report these to your pharmacist or doctor.
- Your team may adjust and individualize your triazolam dose or monitor you more closely.
- They might consider switching you to a benzodiazepine cleared a different way, such as lorazepam, oxazepam, or temazepam, which are less affected by omeprazole.
Bring up any daytime sleepiness or falls at your next visit so they can fine-tune your plan.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A case report by 4 documents a 75-year old man with bleeding from a gastric ulcer who had trouble waking up and displayed an abnormal gait. In the months preceding the hemorrhage, he had been using triazolam 0.25 mg daily for insomnia and lorazepam 1.5 mg daily for anxiety. After the gastric bleed, he was begun on omeprazole 20 mg daily. Twenty days following the gastric hemorrhage, the patient was alert and oriented but exhibited an ataxic gait. Triazolam and lorazepam were both stopped, and the patient's gait returned to its prior state. Ten days afterward, omeprazole was stopped and triazolam therapy was resumed. His gait did not change. Nonetheless, when the patient experienced a further episode of gastric hemorrhage and omeprazole was restarted, the ataxia reappeared. Stopping triazolam was required for the patient to regain his normal gait.
Common questions
Can I take Omeprazole and Triazolam together?
Omeprazole can slow the breakdown of triazolam, making it stronger and longer-lasting, so watch for extra drowsiness and unsteadiness and ask your care team whether your dose should be adjusted or a different sleep medicine used. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Omeprazole and Triazolam 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 is the Omeprazole and Triazolam interaction managed?
The good news is your care team can manage this easily. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Watch for extra drowsiness, grogginess, unsteadiness, or slurred speech, and report these to your pharmacist or doctor. Your team may adjust and individualize your triazolam dose or monitor you more closely. They might consider switching you to a benz… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Omeprazole or Triazolam 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 (5)
- Andersson T, Cederberg C, Edvardsson G, et al: Effect of omeprazole treatment on diazepam plasma levels in slow versus normal rapid metabolizers of omeprazole. Clin Pharmacol Ther 1990; 47:79-85. PubMed
- Gugler R & Jensen JC: Omeprazole inhibits elimination of diazepam (letter). Lancet 1984; 1:969. DOI
- von Herrath D & Thimme W: Wechselwirkungen von omeprazole und cimetidine mit diazepam. Der Arzneimittelbrief 1993; 27:87.
- Marti-Masso JF: Ataxia following gastric bleeding due to emoprazole-benzodiazepine interaction (letter). Ann Pharmacother 1992; 26:429-430.
- Product Information: Prilosec(R), omeprazole. Astra Merck Inc. Wayne, PA, 1997. DailyMed
Keep reading about Triazolam
Keep reading about Omeprazole
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