Investigation and countermeasure of mirtazapine prescription drug interaction based on Lexicomp and Medscape database
Objective To analyze drug interactions in the outpatient prescription of mirtazapine in the department of Mental Health,Bengbu First People's Hospital,and to promote the rational use of medication.Methods A retrospective study was conducted to obtain the outpatient prescriptions for mirtazapine co-administration in the department from January 1,2022 to June 30,2023 from the information system,drug interactions were identified based on Lexicomp and Medscape database,respectively,and merged according to the newly classified drug interactions severity grading.The incidence of mirtazapine-associated drug interactions was descriptive statisticed,the strength of concordance of the severity grading of drug interactions and the risk points between and among the Lexicomp,Medscape,and Lexicomp + Medscape database were tested by Kappa test.Results A total of 402 effective prescriptions were obtained according to the allotting standard,and the drug interactions prescriptions were 402(100%),383(95.3%)and 402(100%)according to Lexicomp,Medscape,and Lexicomp + Medscape database,respectively.In terms of severity classification and risk points,Lexicomp + Medscape database and Lexicomp database were strongly consistent(Kappa>0.99,P = 0),while Lexicomp + Medscape database or Lexicomp and Medscape database were significantly different(Kappa<0,P<0.05).Lexicomp and Medscape database are complementary in terms of risk points.In the 620 cases of Lexicomp + Medscape database drug interactions,miltazapine,buspirone,paroxetine,and other antidepressants had severe drug interactions(5-HT syndrome)of 39.2%,which should be avoided.Drug interactions with sedative hypnotics and antischizophrenic drugs were moderate,up to 60.8%,and should be closely monitored or changed.Conclusion There are severe and moderate drug interactions between mirtazapine and other drugs in Bengbu First People's Hospital,and it's necessary to strengthen the training on the essentials of mirtazapine drug interactions based on the Lexicomp + Medscape database,and to adopt informational controls to prevent risks.
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