Pharmacokinetic and pharmacodynamic interaction study between midazolam and the macrolide antibiotics, erythromycin, clarithromycin, and the azalide azithromycin

Int J Clin Pharmacol Ther. 1997 Dec;35(12):577-9.

Abstract

This report includes a recalculation of the pooled data of 2 pharmacokinetic and pharmacodynamic studies of the interaction between the hypnotic midazolam and the antibiotics erythromycin, clarithromycin (macrolides), and azithromycin (an azalide). Erythromycin and clarithromycin similarly and strikingly impaired the metabolism of midazolam and enhanced its pharmacodynamic activity; little or no effect was found with azithromycin. It was concluded that coadministration of midazolam and azithromycin involves less clinical risk than with the 2 macrolides.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Anti-Anxiety Agents / blood
  • Anti-Anxiety Agents / pharmacokinetics*
  • Anti-Anxiety Agents / pharmacology
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacology*
  • Area Under Curve
  • Azithromycin / administration & dosage
  • Azithromycin / pharmacology*
  • Clarithromycin / administration & dosage
  • Clarithromycin / pharmacology
  • Cross-Over Studies
  • Drug Interactions
  • Erythromycin / administration & dosage
  • Erythromycin / pharmacology
  • Female
  • Humans
  • Male
  • Midazolam / blood
  • Midazolam / pharmacokinetics*
  • Midazolam / pharmacology

Substances

  • Anti-Anxiety Agents
  • Anti-Bacterial Agents
  • Erythromycin
  • Azithromycin
  • Clarithromycin
  • Midazolam