Carbamazepine reduces the AUC and peak
serum levels of
midazolam by about 90%, when compared with
control subjects not taking antiepileptics. The effects of
midazolam were also reduced.
Expect to need to use a much larger dose of
midazolam in the presence of
carbamazepine. An alternative hypno-sedative may be needed.
Other benzodiazepines
The use of benzodiazepines with
carbamazepine is common, although some evidence suggests that the effects of the benzodiazepines are sometimes reduced (alprazolam,
clonazepam,
diazepam, zopiclone).
No action needed, but be aware that sometimes the effects of the benzodiazepines may be reduced.