Drug interactions
Citalopram + Mirtazapine
Severity: Moderate
Citalopram 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 can prolong the QT interval, though mirtazapine's effect is mainly seen in overdose or with other risk factors. The combination also carries some risk of serotonin toxicity. Together they may increase arrhythmia risk in susceptible patients.
What this interaction means in plain words
Citalopram 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.
Citalopram belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with additive serotonergic activity.
What to do
Use the lowest effective doses and keep citalopram within its maximum labeled dose for age and hepatic status. Obtain an ECG and electrolytes in patients with cardiac risk factors and monitor for serotonin syndrome.
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 Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine 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 Citalopram with Mirtazapine?
MediHelp rates the interaction as moderate. Citalopram 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 can prolong the QT interval, though mirtazapine's effect is mainly seen in overdose or with other risk factors. The combination also carries some risk of serotonin toxicity. Together they may increase arrhythmia risk in susceptible patients.
How serious is the interaction between Citalopram 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: Use the lowest effective doses and keep citalopram within its maximum labeled dose for age and hepatic status. Obtain an ECG and electrolytes in patients with cardiac risk factors and monitor for serotonin syndrome.
What other medicines interact with Citalopram?
MediHelp also lists interactions of Citalopram with, for example, Cisapride, Dronedarone, Escitalopram. The full list is on the Citalopram page.
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