ACTION OF THE BENZODIAZEPINES MAY BE POTENTIATED BY ANTICONVULSANTS, ANTIHISTAMINES, ALCOHOL, BARBITURATES, MONOAMINE OXIDASE INHIBITORS, NARCOTICS, PHENOTHIAZINES, PSYCHOTROPIC MEDICATIONS, OR OTHER DRUGS THAT PRODUCE CNS DEPRESSION. SMOKERS HAVE AN INCREASED CLEARANCE OF BENZODIAZEPINES AS COMPARED TO NONSMOKERS.
COMPOUNDS THAT ARE POTENT CYP3A INDUCERS (SUCH AS CARBAMAZEPINE, PHENYTOIN, RIFAMPIN, AND BARBITURATES) WOULD BE EXPECTED TO DECREASE ESTAZOLAM CONCENTRATIONS. METABOLISM OF ESTAZOLAM IS CATALYZED BY CYP3A. CONSEQUENTLY, ESTAZOLAM SHOULD BE AVOIDED IN PATIENTS RECEIVING KETOCONAZOLE AND ITRACONAZOLE, NEFAZODONE, FLUVOXAMINE, CIMETIDINE, DILTIAZEM, ISONIAZIDE, AND SOME MACROLIDE ANTIBIOTICS. ESTAZOLAM IS VERY UNLIKELY TO INHIBIT THE BIOTRANSFORMATION OF OTHER DRUGS METABOLIZED BY THESE CYP ISOFORMS.