Drug interactions
Midazolam intranasal + Mirtazapine
Severity: Moderate
Midazolam 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
Mirtazapine adds to the CNS and respiratory depressant effects of midazolam, increasing the risk of prolonged sedation and hypoventilation. Its CYP3A4 inhibition is negligible, so the pharmacodynamic effect is the main concern.
What this interaction means in plain words
Midazolam 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 CNS depression through GABA-A modulation and mirtazapine's sedative activity.
What to do
Monitor respiratory rate, oxygen saturation and level of consciousness after dosing, and have resuscitation equipment available. Avoid additional sedatives and alcohol.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Midazolam intranasal and Mirtazapine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 intranasal with Mirtazapine?
MediHelp rates the interaction as moderate. Midazolam 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. Mirtazapine adds to the CNS and respiratory depressant effects of midazolam, increasing the risk of prolonged sedation and hypoventilation. Its CYP3A4 inhibition is negligible, so the pharmacodynamic effect is the main concern.
How serious is the interaction between Midazolam 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 respiratory rate, oxygen saturation and level of consciousness after dosing, and have resuscitation equipment available. Avoid additional sedatives and alcohol.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
