Dizziness midazolam

Efavirenz (Sustiva) [Antiretroviral/NNRTI] Uses Hiv infxns Action Antiretroviral nonnucleoside RTI Dose Adults. 600 mg/d PO qhs Feds. See package insert avoid high-fat meals Caution [D, ] CDC recommends HIV-infected mothers not breast-feed Contra Component sensitivity Disp Caps SE Somnolence, vivid dreams, dizziness, rash, N/V/D Interactions T Effects W/ ritonavir T effects OF CNS depressants, ergot derivatives, midazolam, ritonavir, simvastatin, triazolam, warfarin X effects W/ carbamazepine, phenobarbital, rifabutin, rifampin, saquinavir, St. John s wort i effects OF amprenavir, carbamazepine, clarithromycin, indinavir, phenobarbital, saquinavir, warfarin may alter effectiveness OF OCPs EMS Concurrent EtOH usage can t CNS d ression OD May cause muscle contractions and adverse CNS effects activated charcoal may be effective... 

The side effects of efavirenz include dizziness, insomnia, impaired concentration, abnormal dreams, and drowsiness. The most common adverse effect is a skin rash. Other side effects are diarrhea, headache, and dizziness. Efavirenz is recommended to be taken at bedtime with or without food. Patients on efavirenz should avoid driving or operating machinery and the intake of high fat meals. It should always be taken in combination with at least one other anti-HIV agent. Efavirenz is contraindicated with midazolam, triazolam, or ergot derivatives. 

Diclofenac reduces the dose of midazolam needed to produce sedation and hypnosis. Diazepam has a small effect on the pharmacokinetics of diclofenac, ibuprofen and naproxen. Diazepam and indometacin appear not to interact adversely, although feelings of dizziness may be increased. Zaleplon and ibuprofen appear not to interact... 

In a multicenter, double-blind, placebo-controlled study of the effects of intravenous flumazenil 0.7 mg in reversing the effects of midazolam, 82% of 131 flumazenil-treated patients had complete reversal of sedation, compared with 15% of 65 placebo-treated patients. However, flumazenil reversed midazolam-induced amnesia in only 60% of patients. Dizziness (10%) and nausea (9%) were the most common adverse effects [96 ]. Similar results were obtained in a double-blind, placebo-controlled study in patients who had been given midazolam plus an opioid (fentanyl, pethidine, or morphine) [97 ], intravenous diazepam [98 "], or diazepam plus an opioid [99 ]. 

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