The short answer
Valeriana officinalis may add to midazolam-related drowsiness or impairment. A human enzyme-probe study did not show a significant metabolic effect, but that does not exclude additive sedation.
What this answer covers
Confirmed Valeriana officinalis preparations; not an unidentified valerian root or another species.
- Supplement or preparation
- Valeriana officinalis
- Medication ingredient
- midazolam
The precaution concerns alertness
Valerian guidance cautions about other sedating substances. Midazolam labels describe CNS and respiratory-depressant effects, supporting a precaution without establishing this pair’s event rate.
The metabolic study was negative
A human probe study found no significant effect of the tested valerian preparation on CYP activity. This is relevant contrary evidence to an enzyme-interaction theory, but it did not establish the absence of combined sedation.
Sleep benefits do not establish co-use safety
A separate valerian trial did not establish sleep benefit and did not test midazolam. Both efficacy and safety depend on the preparation, and neither study defines a safe combined dose.
Inform the team before a procedure
Tell the treating team about valerian and the exact midazolam formulation. No short spacing interval is proven protection. Follow prescribed rescue instructions and seek urgent help for serious breathing problems or inability to wake.
Evidence and practical considerations
Side effects & toxicity
Exact Valeriana officinalis identity permits a conditional additive-sedation precaution; direct probe CYP null retained, no exact pair incidence.
- Exact scope
- Confirmed Valeriana officinalis preparations; not an unidentified valerian root or another species. with Midazolam6960 IN; oral hydrochloride syrup, IV/IM hydrochloride and intranasal midazolam distinguished.
- Medication form and route
- oral medication; intravenous medication; intramuscular medication; intranasal medication; oral supplement
What remains uncertain
- No unmeasured pair incidence, blanket class transfer or arbitrary spacing interval.
Factors that may matter: Preparation; Dose; Other medicines; Organ function.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed midazolam
CYP3A metabolism, CNS-depressant and respiratory risks; not intended for chronic home sedation.
How this applies: Exact midazolam RxCUI 6960 IN, with stated salt/formulation/route bridge.
Adult oral probe trials not automatic pediatric dosing or nasal/injection interaction magnitude.
Source 2: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed midazolam
Sedation/respiratory and CYP3A interaction precautions.
How this applies: Exact midazolam RxCUI 6960 IN, with stated salt/formulation/route bridge.
Bypasses intestinal absorption; oral exposure findings cannot be assigned unchanged.
Source 3: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed midazolam
CNS-depressant and CYP3A interaction precautions; formulation-specific rescue instructions.
How this applies: Exact midazolam RxCUI 6960 IN, with stated salt/formulation/route bridge.
Not oral procedural dosing; do not delay prescribed seizure rescue to implement an invented herbal gap.
Source 4: federal supplement safety guidance
nccih.nih.gov · Source check Sep 10, 2026
Population: Users of the specified supplement.
Possible but unproven sleep-inducing effects; advises against combining valerian with alcohol or sedatives.
How this applies: Original source interpreted for midazolam only within the stated preparation and endpoint limits.
Not a direct midazolam combination trial; original preparation, dose and endpoint limits apply. No exact-pair adverse-event rate or protective spacing established.
Source 5: federal botanical identity and safety guidance
ods.od.nih.gov · Source check Sep 10, 2026
Population: Users of Valeriana officinalis.
The fact sheet covers only V. officinalis among more than 250 valerian species; possible additive sedation is theoretical.
How this applies: Original source interpreted for midazolam only within the stated preparation and endpoint limits.
Not a direct midazolam combination trial; original preparation, dose and endpoint limits apply. No exact-pair adverse-event rate or protective spacing established.
Source 6: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 391 participants with anxiety and insomnia.
Neither botanical improved its primary anxiety/insomnia outcome over placebo.
How this applies: Original source interpreted for midazolam only within the stated preparation and endpoint limits.
Not a direct midazolam combination trial; original preparation, dose and endpoint limits apply. No exact-pair adverse-event rate or protective spacing established.
Source 7: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 12 healthy adults.
No significant valerian effect on tested CYP phenotypes.
How this applies: Probe metabolic ratios, not a trial powered for additive sedation; one preparation.
Probe metabolic ratios, not a trial powered for additive sedation; one preparation.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Research summary published | |
| Article prepared | |
| Prepared exact midazolam article with formulation-specific evidence and uncertainty. |
Article revision: 6fa24f972a4a0d41
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.