Temazepam Erythromycin

Clinically important, potentially hazardous interactions with amlodipine, anisindione, anticoagulants, aprepitant, atorvastatin, barbiturates, benzodiazepines, butabarbital, carbamazepine, chlordiazepoxide, clarithromycin, clonazepam, dorazepate, corticosteroids, cyclosporine, dexamethasone, diazepam, dicumarol, erythromycin, ethotoin, felodipine, flurazepam, fluvastatin, fosphenytoin, isradipine, itraconazole, ketoconazole, lorazepam, lovastatin, mephenytoin, mephobarbital, midazolam, nicardipine, nifedipine, nimodipine, nisoldipine, oxazepam, pentobarbital, phenobarbital, pimozide, pravastatin, primidone, quazepam, rifampin, secobarbital, simvastatin, St John s wort, temazepam, warfarin... 

With the exception of temazepam, which is eliminated by conjugation, all benzodiazepine hypnotics are metabolized by hepatic microsomal oxidation and then undergo glucuronide conjugation. Oxidation may be inhibited in patients with impaired liver function, advanced age, or concurrent use of drugs that inhibit oxidation. Drugs that inhibit the cytochrome P450 3A4 enzyme (e.g., erythromycin, nefazodone, fluvoxamine, and ketoconazole) reduce the clearance of triazolam and increase its plasma concentrations."... 

A randomised, study in 10 healthy subjects found that erythromycin 500 mg three times daily for 6 days had no significant effect on the pharmacokinetics or psychomotor effects of a single 20-mg dose of temazepam. ... 

Azithromycin does not interact with midazolam or triazolam, and the effects of roxithromycin on midazolam and triazolam, and of erythromycin on diazepam, flunitrazepam, nitrazepam, temazepam and zopiclone or clarithromycin on zolpidem appear to be small and unimportant, or the effects negligible, so that no special precautions seem to be necessary. 

Luurila H, Olkkola KT, Neuvonen PJ. Lack of interaction of erythromycin and temazepam. TherDrugMonit ( 994) 16, 548-51. 

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