Midazolam and Verapamil Interaction
Drug interaction information between Midazolam and Verapamil.
Midazolam and Verapamil have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Midazolam and Verapamil. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Verapamil interferes with the liver enzyme responsible for clearing midazolam from your body. This causes the midazolam to stay in your blood for a longer period of time.
What To Do
Your doctor should use caution when giving these drugs together. Be aware that the sedative effects of midazolam may last longer than expected.
FDA Label Information
Other Drug Interactions Caution is advised when midazolam is administered concomitantly with drugs that are known to inhibit the P450-3A4 enzyme system such as cimetidine (not ranitidine), erythromycin, diltiazem, verapamil, ketoconazole and itraconazole. The effects of diltiazem (60 mg tid) and verapamil (80 mg tid) on the pharmacokinetics and pharmacodynamics of midazolam were investigated in a three-way crossover study (n=9). The half-life of midazolam increased from 5 to 7 hours when midazolam was taken in conjunction with verapamil or diltiazem.
Midazolam Also Interacts With
- Darunavir major
- Itraconazole major
- Nirmatrelvir/Ritonavir major
- Ketoconazole moderate
- Erythromycin moderate
Verapamil Also Interacts With
- Eplerenone major
- Ezetimibe major
- Ezetimibe/Simvastatin major
- Simvastatin major
- Clarithromycin moderate
Frequently Asked Questions
Can I take Midazolam and Verapamil together?
This is a moderate interaction. Your doctor should use caution when giving these drugs together. Be aware that the sedative effects of midazolam may last longer than expected.
How serious is the interaction between Midazolam and Verapamil?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Midazolam and Verapamil interact?
Verapamil interferes with the liver enzyme responsible for clearing midazolam from your body. This causes the midazolam to stay in your blood for a longer period of time.
Understanding the Midazolam and Verapamil Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Midazolam belongs to the Benzodiazepine class and Verapamil belongs to the Calcium Channel Blocker class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Verapamil interferes with the liver enzyme responsible for clearing midazolam from your body. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Midazolam has 39 total documented interactions on file in this dataset, and Verapamil has 57. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should use caution when giving these drugs together. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Midazolam or Verapamil based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.