Drug interactions
Artemether / lumefantrine + Mirtazapine
Severity: Major
Artemether / lumefantrine and Mirtazapine: major interaction.
Last updated Sources: US FDA label
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
Artemether/lumefantrine can prolong the QT interval, and its labeling warns against use with other QT-prolonging drugs. Mirtazapine may add to the risk of arrhythmia, and lumefantrine is also a CYP2D6 inhibitor, which may raise mirtazapine levels.
What this interaction means in plain words
Artemether / lumefantrine and Mirtazapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive QT prolongation, with possible modest CYP2D6 inhibition by lumefantrine raising mirtazapine exposure.
What to do
Avoid the combination where an alternative exists, or withhold mirtazapine during the short antimalarial course. If used together, obtain an ECG and correct potassium and magnesium.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Artemether / lumefantrine with Mirtazapine?
MediHelp rates the interaction as major. Artemether / lumefantrine and Mirtazapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Artemether/lumefantrine can prolong the QT interval, and its labeling warns against use with other QT-prolonging drugs. Mirtazapine may add to the risk of arrhythmia, and lumefantrine is also a CYP2D6 inhibitor, which may raise mirtazapine levels.
How serious is the interaction between Artemether / lumefantrine and Mirtazapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where an alternative exists, or withhold mirtazapine during the short antimalarial course. If used together, obtain an ECG and correct potassium and magnesium.
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.
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