Drug interactions
Dihydroergotamine intranasal + Mirtazapine
Severity: Moderate
Dihydroergotamine intranasal and Mirtazapine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both agents have serotonergic activity, so serotonin toxicity is a theoretical concern when they are combined. Intranasal dihydroergotamine is used intermittently for migraine, which limits cumulative exposure.
What this interaction means in plain words
Dihydroergotamine intranasal and Mirtazapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive serotonergic effects from mirtazapine and 5-HT1 receptor agonism by dihydroergotamine.
What to do
Monitor for signs of serotonin syndrome such as agitation, tremor, sweating and hyperreflexia after dosing. Discontinue the serotonergic drugs and treat supportively if it occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Frequently asked questions
Can I take Dihydroergotamine intranasal with Mirtazapine?
MediHelp rates the interaction as moderate. Dihydroergotamine intranasal and Mirtazapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both agents have serotonergic activity, so serotonin toxicity is a theoretical concern when they are combined. Intranasal dihydroergotamine is used intermittently for migraine, which limits cumulative exposure.
How serious is the interaction between Dihydroergotamine intranasal and Mirtazapine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for signs of serotonin syndrome such as agitation, tremor, sweating and hyperreflexia after dosing. Discontinue the serotonergic drugs and treat supportively if it occurs.
What other medicines interact with Mirtazapine?
MediHelp also lists interactions of Mirtazapine with, for example, Isocarboxazid, Phenelzine, Pimozide. The full list is on the Mirtazapine page.
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