Drug interactions
Ceritinib + Mirtazapine
Severity: Major
Ceritinib 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
Ceritinib prolongs the QT interval and inhibits CYP3A4, which contributes to mirtazapine clearance. Together they may increase mirtazapine exposure and arrhythmia risk.
What this interaction means in plain words
Ceritinib 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.
Ceritinib belongs to Oncology; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation plus CYP3A4 inhibition by ceritinib raising mirtazapine levels.
What to do
Avoid the combination if possible. If used, obtain ECGs, correct electrolytes and monitor for mirtazapine adverse effects, reducing the dose if needed.
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
- Mirtazapine 15 mg film-coated tablets - SmPC sections 4.3/4.5 (class statement: medicines which prolong the QTc interval; "The risk of QT prolongation and/or ventricular arrhythmias (e.g. Torsades de Pointes) may be increased with concomitant use of medicines which prolong the QTc i") — electronic medicines compendium (UK SmPC)
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 Ceritinib
- Ceritinib + Cisapride Contraindicated
- Ceritinib + Eletriptan Contraindicated
- Ceritinib + Flibanserin Contraindicated
- Ceritinib + Pimozide Contraindicated
- Ceritinib + Thioridazine Contraindicated
- Ceritinib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Ceritinib with Mirtazapine?
MediHelp rates the interaction as major. Ceritinib 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. Ceritinib prolongs the QT interval and inhibits CYP3A4, which contributes to mirtazapine clearance. Together they may increase mirtazapine exposure and arrhythmia risk.
How serious is the interaction between Ceritinib 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: Avoid the combination if possible. If used, obtain ECGs, correct electrolytes and monitor for mirtazapine adverse effects, reducing the dose if needed.
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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