Midazolam Eplerenone

This approach can be easily reproduced with other CYP3A-sensitive substrates, such as buspirone, triazolam, and eplerenone, and yields quantitative examination of the relationship between these sensitive substrates and midazolam. This question was pursued in some depth by Ragueneau-Majlessi et al. (22) and showed that classification of inhibitors (five moderate and eight potent) was substrate independent in 74% to 83% of the instances. Exceptions pertained to buspirone and simvastatin that seemed to be systematically more sensitive than midazolam and saquinavir that appeared less sensitive (22). Furthermore, results of this analysis allow an extrapolation of the inhibitory effect of a compound from one probe to another avoiding a duplication of studies (i.e., effects of inhibitor on simvastatin calculated from its effect on midazolam). 

Clinically important, potentially hazardous interactions with alfentanil, aminophylline, amisulpride, amoxicillin, ampicillin, anticonvulsants, astemizole, atorvastatin, benzodiazepines, bromocriptine, buprenorphine, bupropion, carbamazepine, cilostazol, ciprofloxacin, cisapride, clindamycin, colchicine, cyclosporine, dasatinib, digoxin, dihydroergotamine, diltiazem, disopyramide, enoxacin, eplerenone, ergotamine, eszopiclone, everolimus, fluconazole, fluoxetine, fluvastatin, gatifloxacin, HMG-CoA reductase inhibitors, imatinib, itraconazole, ketoconazole, lomefloxacin, lorazepam, lovastatin, methadone, methylprednisolone, methysergide, midazolam, mizolastine, moxifloxacin, nitrazepam, norfloxacin, ofloxacin, paroxetine, pimozide, pravastatin, quinolones, ranolazine, repaglinide, rupatadine, sertraline, sildenafil, simvastatin, sparfloxacin, sulpiride, tacrolimus, terfenadine, triazolam, troleandomycin, vardenafil, verapamil, vinblastine, warfarin, zaleplon, zolpidem, zuclopenthixol... 

Clinically important, potentially hazardous interactions with alprazolam, amphotericin B, anisindione, anticoagulants, dicumarol, eplerenone, erythromycin, methadone, midazolam, phenobarbital, phenytoin, ramelteon, sulfonylureas, trabectedin, vinblastine, vincristine, warfarin... 

Clinically important, potentially hazardous interactions with alfuzosin, alprazolam, amphotericin B, anisindione, antacids, aprepitant, astemizole, atorvastatin, bosentan, ciclesonide, cimetidine, clorazepate, conivaptan, cyproterone, dasatinib, dexamethasone, dicumarol, didanosine, eplerenone, erythromycin, ethotoin, fentanyl, fesoterodine, fosamprenavir, fosphenytoin, grapefruit juice, HMG-CoA reductase inhibitors, imatinib, ixabepilone, lapatinib, lopinavir, lovastatin, mephenytoin, methylprednisolone, micafungin, midazolam, nilotinib, pimozide, prednisolone, prednisone, quinidine, rifampin, rimonabant, rivaroxaban, sildenafil, silodosin, simvastatin, sirolimus, solifenacin, temsirolimus, terfenadine, tolvaptan, triazolam, vardenafil, vinblastine, vincristine, warfarin... 

Clinically important, potentially hazardous interactions with alprazolam, astemizole, clindamycin, darunavir, dasatinib, dihydroergotamine, eplerenone, ergot derivatives, fentanyl, garlic, ixabepilone, ketoconazole, lapatinib, methysergide, midazolam, phenytoin, pimozide, rifampin, ritonavir, sildenafil, solifenacin, St John s wort, temsirolimus, tolvaptan... 

Caution is recommended when eplerenone is used with alpha blockers, antipsychotics, amifostine, baclofen, corticosteroids, tetracosactide and tricyclic antidepressants. Lithium, ciclosporin, and tacrolimus should generally not be used with eplerenone. Antacids, cisapride, midazolam and simvastatin had no effect on eplerenone pharmacokinetics. Eplerenone had no important effect on cisapride, midazolam, warfarin or contraceptive steroid pharmacokinetics, but caused a slight increase in digoxin levels. 

A pharmacokinetic study has shown no pharmacokinetic interaction between midazolam (a cytochrome P450 isoenzyme CYP3A4 substrate) and eplerenone. ... 

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