Drug interactions
Alprazolam + Mirtazapine
Severity: Moderate
Alprazolam 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, so taking them together can produce stronger drowsiness, slowed reaction time and impaired psychomotor performance. Older adults and patients driving or operating machinery are at greatest risk.
What this interaction means in plain words
Alprazolam 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.
Alprazolam belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive CNS depression through GABA-A potentiation by alprazolam and H1 antagonism by mirtazapine.
What to do
Start with the lowest effective doses and counsel patients about driving and alcohol. Reduce the dose of either drug if excessive sedation or confusion appears.
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 Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Mirtazapine?
MediHelp rates the interaction as moderate. Alprazolam 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, so taking them together can produce stronger drowsiness, slowed reaction time and impaired psychomotor performance. Older adults and patients driving or operating machinery are at greatest risk.
How serious is the interaction between Alprazolam 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: Start with the lowest effective doses and counsel patients about driving and alcohol. Reduce the dose of either drug if excessive sedation or confusion appears.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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