How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask William Pflugfelder Your Own Question
William Pflugfelder
William Pflugfelder, Pharmacist
Category: Pharmacy
Satisfied Customers: 23
Experience:  Pharmacist at Health Care Consultants
Type Your Pharmacy Question Here...
William Pflugfelder is online now
A new question is answered every 9 seconds

My name is ***** *****, I have a drug interaction question.

Customer Question

Hi my name is ***** *****, I have a drug interaction question. I need some information about Mirtazapine.
JA: Thanks. Can you give me any more details about your issue?
Customer: I have just been placed on Mirtazapine and have severe insomnia too and suffer from migraines. My question is the safety of taking Avanza and stillnox, and Avanza and Imigran.
JA: OK got it. Last thing — Pharmacists generally expect a deposit of about $18 to help with your type of question (you only pay if satisfied). Now I'm going to take you to a page to place a secure deposit with JustAnswer. Don't worry, this chat is saved. After that, we will finish helping you.
Submitted: 9 months ago.
Category: Pharmacy
Expert:  William Pflugfelder replied 9 months ago.

Good morning. Mortalities should probably help with the insomnia. Let me see what I can find out about the interaction question. Is the same prescriber writing for all 3 medications or are they from different prescriber's?

Expert:  William Pflugfelder replied 9 months ago.

DrBillRPh here,

If drug 2 is avinza (morphine Sulfate) then all 3 drugs do cause sedation and central nervous system depression. The effects are additive. Caution is advised and your prescriber(s) should be aware of the combination you are taking and the additive effects. If you are just starting the mirtazipine then you may be able to omit the stillnox. Over time the mirtazipine will become more effective as the drug level in your body reaches a therapeutic concentration. Hope helpful,


Expert:  Dr. Bridget replied 9 months ago.

Hi Millie,

I can help with your drug interactions question. You would like to know if there are any interactions between Imigran (Sumatriptan), Avanza (Mirtazepine) and Stilnox (Zolpidem). The good news is that these medications can be taken together safely with the proper monitoring. Avanza and Imigran have a small risk of causing sertonin syndrome when used together, but this does not commonly occur and very low risk for you as you are likely not taking Imigran every day. Avanza and Stilnox cause more drowsiness than taking either alone, but this will be a welcome side effect since you suffer from insomnia. If you have any further questions/comments, just reply:) If you got what you need, please take a moment to provide me a positive rating. Thank you!

Expert:  William Pflugfelder replied 9 months ago.

My apology Millie,

Avanza is indeed mirtazapine as you well know. Mirtazapine and zolpidem do have an additive effect with regard to sedation and CNS depression Please pardon the confusion.

Related Pharmacy Questions