Drug Interaction Report

Ranitidine and Midazolam Injection: Interaction Details

Name: Ranitidine and Midazolam Injection Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Ranitidine and Midazolam Injection 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

Ranitidine

No brand names on record

Midazolam Injection

Nayzilam Versed® Injection

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Moderate

Can be significant — usually manageable with monitoring.

Minor

Moderate

Major

Contraindicated

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 45 documented Ranitidine interactions, 12 are rated moderate — including this one.

Onset

unspecified

Evidence

theoretical

Severity

Moderate

What happens

Increased midazolam bioavailability

Interaction Deep Dive

Concomitant use of midazolam and ranitidine may result in increased midazolam bioavailability due to decreased gastric pH induced by ranitidine. Monitor the patient for signs of midazolam toxicity if concomitant use is necessary¹².

Why it happens (mechanism)

Decreased gastric acidity

Common questions

Can I take Ranitidine and Midazolam Injection together?

Increased midazolam bioavailability Always confirm with your pharmacist or prescriber before making any change.

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

Questions for your pharmacist

Does my dose of Ranitidine 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 anything you'd monitor while I'm on both?

References (2)

Product Information: ZANTAC(R) oral effervescent tablets, oral syrup, oral tablets, ranitidine hcl oral effervescent tablets, oral syrup, oral tablets. GlaxoSmithKline, Triangle Park, NC, 2009. DailyMed
Product Information: ZANTAC(R) injection, injection premixed, ranitidine hcl injection, injection premixed. GlaxoSmithKline, Research Triangle Park, NC, 2009. DailyMed

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Ranitidine

Keep reading about Ranitidine

All Ranitidine interactions (45)

Also serious with: Gefitinib Nifedipine Octreotide Injection Cyclosporine Ophthalmic

Midazolam Injection

Keep reading about Midazolam Injection

All Midazolam Injection interactions (276) Midazolam Injection drug information

Also serious with: Nelfinavir Nirmatrelvir Ritonavir Saquinavir

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:

Ranitidine + Activated Charcoal St. John's Wort African Wild Potato Banderol Beer Bitter Melon Black Pepper Bulbine Natalensis + 66 more

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

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A message from HelloPharmacist

About our interaction database: depth, not breadth

HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

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.