Drug interactions
Clarithromycin + Mirtazapine
Severity: Moderate
Clarithromycin 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
Clarithromycin may increase mirtazapine concentrations, and both agents can prolong the QT interval. This raises the risk of sedation, and rarely of arrhythmia, particularly in patients with other risk factors.
What this interaction means in plain words
Clarithromycin 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.
Clarithromycin belongs to Anti Bacterial; Mirtazapine belongs to Central Nervous System.
Why it happens
CYP3A4 inhibition by clarithromycin reduces mirtazapine clearance, with additive QT effects.
What to do
Monitor for excess sedation and consider an ECG in patients with cardiac risk factors or electrolyte disturbance. Consider azithromycin or a non-macrolide if risk is high.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clarithromycin and Mirtazapine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine 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 Clarithromycin with Mirtazapine?
MediHelp rates the interaction as moderate. Clarithromycin 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. Clarithromycin may increase mirtazapine concentrations, and both agents can prolong the QT interval. This raises the risk of sedation, and rarely of arrhythmia, particularly in patients with other risk factors.
How serious is the interaction between Clarithromycin 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 excess sedation and consider an ECG in patients with cardiac risk factors or electrolyte disturbance. Consider azithromycin or a non-macrolide if risk is high.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
