BENZODIAZEPINES AND MACROLIDES - MIDAZOLAM, TRIAZOLAM OR ZOPICLONE

The serum levels and effects of midazolam and triazolam are markedly increased and prolonged by erythromycin. Similar effects occur when triazolam is given with clarithromycin, josamycin and possibly telithromycin, and when midazolam is given with clarithromycin and possibly telithromycin. Plasma levels of zopiclone are markedly increased by erythromycin.
The benzodiazepine dose should be reduced in the presence of these macrolides if excessive effects (marked drowsiness, memory loss) are to be avoided. Note that the hypnotic effects may also be prolonged. Other macrolides may also interact, although it seems unlikely that they all will, see macrolides.