Drug interactions
Bosentan + Mirtazapine
Severity: Moderate
Bosentan 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
Bosentan is a moderate CYP3A4 inducer, and mirtazapine is partly cleared by CYP3A4. Bosentan may lower mirtazapine concentrations, which could reduce its antidepressant effect.
What this interaction means in plain words
Bosentan 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.
Bosentan belongs to Miscellaneous; Mirtazapine belongs to Central Nervous System.
Why it happens
Bosentan induces CYP3A4, increasing metabolic clearance of mirtazapine.
What to do
Monitor for loss of antidepressant response and increase the mirtazapine dose if needed. Reassess the dose if bosentan is stopped.
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 Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Other interactions of Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Frequently asked questions
Can I take Bosentan with Mirtazapine?
MediHelp rates the interaction as moderate. Bosentan 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. Bosentan is a moderate CYP3A4 inducer, and mirtazapine is partly cleared by CYP3A4. Bosentan may lower mirtazapine concentrations, which could reduce its antidepressant effect.
How serious is the interaction between Bosentan 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: Monitor for loss of antidepressant response and increase the mirtazapine dose if needed. Reassess the dose if bosentan is stopped.
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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