Patient/caregiver was educated on contraindications for using Midazolam as follows:
- Avoid taking Midazolam with grapefruit juice, as it can also inhibit the enzymes needed for the metabolism of Midazolam. Concurrent administration of grapefruit juice with midazolam can inhibit the metabolism of midazolam. Thus, midazolam stays in the body for prolonged duration of time in comparison to normal and stand the risk of causing toxicity.
- Some medications, such as, phenytoin and carbamazepine, induce the enzymes needed for the metabolism of Midazolam. Concurrent administration of these medications with Midazolam can quicken the metabolism of midazolam and clear the medication out of the body quicker. Thus, midazolam stays in the body for shorter duration of time in comparison to normal and results in compromised therapeutic benefit.
- If you are being newly started on Midazolam, discuss with your physician regarding all other medications you are currently taking and their safety with Midazolam. Also, if you have been taking Midazolam for long, discuss with your physician regarding your history of Midazolam intake, when you are being started on any new medication.
- Midazolam is extensively metabolized in the liver and the metabolites are excreted in the urine. If liver function is deficient, the metabolism of Midazolam can be compromised. In individuals with history of compromised renal function, the excretion of midazolam metabolites can be compromised. In either case, midazolam and metabolites stay in the body for prolonged duration of time in comparison to normal leading to increased blood levels of the medication and metabolites for longer periods of time. This can lead to increased risk for side-effects and consequent toxicity. So, Midazolam could be cautiously administered or avoided for an alternative medication, in individuals with hepatic and/or renal dysfunction. Periodical labs for liver and/or renal function could be ordered and individuals monitored for development of any toxic symptoms. Discuss with your physician regarding history of compromised liver or kidney function, if any.
