Drug interactions
Azithromycin + Mirtazapine
Severity: Moderate
Azithromycin 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 can prolong the QT interval, so combining them may increase the risk of torsades de pointes. The risk is higher with overdose, bradycardia, electrolyte disturbance or other QT-prolonging drugs.
What this interaction means in plain words
Azithromycin 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.
Azithromycin belongs to Anti Bacterial; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QTc prolongation via cardiac repolarization effects.
What to do
Check ECG and electrolytes in patients with cardiac risk factors and consider an alternative antibiotic. Monitor for palpitations or syncope.
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 Azithromycin
- Azithromycin + Cisapride Contraindicated
- Azithromycin + Domperidone Contraindicated
- Azithromycin + Dronedarone Contraindicated
- Azithromycin + Pimozide Contraindicated
- Azithromycin + Piperaquine Contraindicated
- Azithromycin + Thioridazine Contraindicated
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 Azithromycin with Mirtazapine?
MediHelp rates the interaction as moderate. Azithromycin 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 can prolong the QT interval, so combining them may increase the risk of torsades de pointes. The risk is higher with overdose, bradycardia, electrolyte disturbance or other QT-prolonging drugs.
How serious is the interaction between Azithromycin 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: Check ECG and electrolytes in patients with cardiac risk factors and consider an alternative antibiotic. Monitor for palpitations or syncope.
What other medicines interact with Azithromycin?
MediHelp also lists interactions of Azithromycin with, for example, Cisapride, Domperidone, Dronedarone. The full list is on the Azithromycin page.
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