Drug interactions
Buprenorphine + Mirtazapine
Severity: Moderate
Buprenorphine 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 may prolong the QT interval, and mirtazapine also adds sedation and has serotonergic activity. Concurrent use may increase arrhythmia risk and CNS depression.
What this interaction means in plain words
Buprenorphine 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.
Buprenorphine belongs to Musculoskeletal; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive CNS depression; possible serotonergic contribution.
What to do
Monitor for sedation and signs of serotonin toxicity, and obtain an ECG if other QT risk factors exist. Start at low doses and titrate gradually.
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 Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + 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 Buprenorphine with Mirtazapine?
MediHelp rates the interaction as moderate. Buprenorphine 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 may prolong the QT interval, and mirtazapine also adds sedation and has serotonergic activity. Concurrent use may increase arrhythmia risk and CNS depression.
How serious is the interaction between Buprenorphine 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 sedation and signs of serotonin toxicity, and obtain an ECG if other QT risk factors exist. Start at low doses and titrate gradually.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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