Drug interactions
Carbamazepine + Mirtazapine
Severity: Moderate
Carbamazepine 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
Carbamazepine markedly lowers mirtazapine plasma concentrations, which can reduce antidepressant effect. Stopping carbamazepine later can allow mirtazapine levels to rise again.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Carbamazepine induces CYP3A4 (and other enzymes), increasing mirtazapine clearance.
What to do
Monitor clinical response and increase the mirtazapine dose if needed. Reduce the dose again if carbamazepine is discontinued.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Mirtazapine?
MediHelp rates the interaction as moderate. Carbamazepine 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. Carbamazepine markedly lowers mirtazapine plasma concentrations, which can reduce antidepressant effect. Stopping carbamazepine later can allow mirtazapine levels to rise again.
How serious is the interaction between Carbamazepine 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 clinical response and increase the mirtazapine dose if needed. Reduce the dose again if carbamazepine is discontinued.
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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