Drug interactions
Brexanolone + Mirtazapine
Severity: Major
Brexanolone and Mirtazapine: major interaction.
Last updated Sources: UK SmPC
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
Brexanolone causes excessive sedation and sudden loss of consciousness in some patients, and other CNS depressants can add to this. Mirtazapine's sedative properties may increase the risk.
What this interaction means in plain words
Brexanolone 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 CNS depression through GABA-A positive modulation plus antihistaminic sedation.
What to do
Monitor continuously for sedation and hypoxia with pulse oximetry during the infusion. Reduce or interrupt the infusion if excessive sedation occurs, and consider holding mirtazapine temporarily.
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 Brexanolone with Mirtazapine?
MediHelp rates the interaction as major. Brexanolone 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. Brexanolone causes excessive sedation and sudden loss of consciousness in some patients, and other CNS depressants can add to this. Mirtazapine's sedative properties may increase the risk.
How serious is the interaction between Brexanolone 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: Monitor continuously for sedation and hypoxia with pulse oximetry during the infusion. Reduce or interrupt the infusion if excessive sedation occurs, and consider holding mirtazapine temporarily.
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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