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Related Experiment Videos

A pharmacokinetic interaction between roxithromycin and midazolam

J T Backman1, K Aranko, J J Himberg

  • 1Department of Clinical Pharmacology, University of Helsinki, Finland.

European Journal of Clinical Pharmacology
|January 1, 1994
PubMed
Summary

Roxithromycin increased midazolam levels in volunteers but had minimal impact on performance. This drug interaction appears less clinically significant than with erythromycin.

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Clinical therapeutics·2016

Area of Science:

  • Pharmacology
  • Drug Interactions
  • Clinical Pharmacology

Background:

  • Macrolide antibiotics like erythromycin can significantly interact with midazolam.
  • Understanding roxithromycin's interaction with midazolam is crucial for patient safety.

Purpose of the Study:

  • To investigate the pharmacokinetic and pharmacodynamic interaction between roxithromycin and midazolam.
  • To determine the clinical significance of this drug interaction.

Main Methods:

  • A double-blind, randomized crossover study involving 10 healthy volunteers.
  • Administration of roxithromycin (300 mg daily for 6 days) or placebo, followed by a 15 mg midazolam dose on day 6.
  • Plasma drug concentrations and psychomotor performance were monitored for 17 hours.

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Main Results:

  • Roxithromycin significantly increased midazolam's area under the concentration-time curve (AUC) from 8.3 to 12.2 µg·ml⁻¹·min.
  • The elimination half-life of midazolam increased from 1.7 to 2.2 hours with roxithromycin.
  • Minor differences in psychomotor performance were observed between treatments.

Conclusions:

  • Roxithromycin alters midazolam pharmacokinetics, increasing its exposure.
  • The observed interaction between roxithromycin and midazolam appears less clinically significant compared to erythromycin.
  • Further clinical evaluation may be warranted for specific patient populations.