Drug interactions
Clomipramine + Mirtazapine
Severity: Moderate
Clomipramine 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 and have sedative effects, and combined use also carries a risk of serotonin toxicity. The combination is sometimes used in resistant depression but needs oversight.
What this interaction means in plain words
Clomipramine 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.
Clomipramine belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, sedation and serotonergic activity.
What to do
Obtain a baseline ECG, correct electrolytes, use the lowest effective doses, and monitor for serotonin syndrome and excessive sedation.
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 Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine 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 Clomipramine with Mirtazapine?
MediHelp rates the interaction as moderate. Clomipramine 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 and have sedative effects, and combined use also carries a risk of serotonin toxicity. The combination is sometimes used in resistant depression but needs oversight.
How serious is the interaction between Clomipramine 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: Obtain a baseline ECG, correct electrolytes, use the lowest effective doses, and monitor for serotonin syndrome and excessive sedation.
What other medicines interact with Clomipramine?
MediHelp also lists interactions of Clomipramine with, for example, Arsenic trioxide, Dofetilide, Droperidol. The full list is on the Clomipramine page.
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