Drug interactions
Midazolam + Mirtazapine
Severity: Moderate
Midazolam 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 drugs cause sedation, and combined use can produce excessive drowsiness, slowed psychomotor function and impaired alertness. The effect is more pronounced in older or frail patients.
What this interaction means in plain words
Midazolam 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.
Midazolam belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive CNS depression from GABA-A potentiation (midazolam) and histamine H1 and other receptor antagonism (mirtazapine).
What to do
Use the lowest effective midazolam dose and monitor level of consciousness and respiration; counsel patients about driving and fall risk.
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 Midazolam
- Atazanavir + Midazolam Contraindicated
- Cobicistat + Midazolam Contraindicated
- Darunavir + Midazolam Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Midazolam Contraindicated
- Fosamprenavir + Midazolam Contraindicated
- Indinavir + Midazolam Contraindicated
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 Midazolam with Mirtazapine?
MediHelp rates the interaction as moderate. Midazolam 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 drugs cause sedation, and combined use can produce excessive drowsiness, slowed psychomotor function and impaired alertness. The effect is more pronounced in older or frail patients.
How serious is the interaction between Midazolam 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: Use the lowest effective midazolam dose and monitor level of consciousness and respiration; counsel patients about driving and fall risk.
What other medicines interact with Midazolam?
MediHelp also lists interactions of Midazolam with, for example, Atazanavir, Cobicistat, Darunavir. The full list is on the Midazolam page.
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