Antipsychotics,Anxiolytics and Hypnotics 725
Clinical evidence,mechanism, importance and management
2.5 mg to 15mg daily; 1 taking betamethasone 0.5mg daily; 1 taking methylprednisolone 48mg daily) and to 10 other patients not taking corticosteroids. In patients taking corticosteroids AUC of midazolam was decreased and clearance increased, when compared with patients not taking corticosteroids; however differences were not significant. The onset of anaesthesia between two groups was also not different. It was suggested that trend towards increased midazolam metabolism may be due to induction of cytochrome P450 isoenzyme CYP3A4 and/or UDP-glucuronosyltransferase. Although results with intravenous metabolism were not significant authors note that it is possible that metabolism of oral midazolam may be more markedly affected (See reference number 1).
1. Nakajima M,Suzuki T, Sasaki T, Yokoi T, Hosoyamada A, Yamamoto T, Kuroiwa Y. Effectsof chronic administration of glucocorticoid on midazolam pharmacokinetics in humans. Ther Drug Monit (1999) 21, 507–13.