Drug interactions
Cyproheptadine + Mirtazapine
Severity: Moderate
Cyproheptadine 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 are strongly H1-blocking and sedating, so combining them can substantially increase drowsiness and impair performance. Mirtazapine's 5-HT2 antagonism overlaps with cyproheptadine's, and the pair adds little therapeutic benefit.
What this interaction means in plain words
Cyproheptadine 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.
Cyproheptadine belongs to Respiratory; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive H1 antagonism and CNS depression with overlapping 5-HT2 blockade.
What to do
Monitor for excessive sedation, especially at treatment start, and advise against driving. Reduce the dose or avoid the combination if daytime impairment occurs.
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 Cyproheptadine
- Cyproheptadine + Isocarboxazid Contraindicated
- Cyproheptadine + Phenelzine Contraindicated
- Cyproheptadine + Tranylcypromine Contraindicated
- Alfentanil + Cyproheptadine Major
- Belladonna and opium + Cyproheptadine Major
- Benzhydrocodone / acetaminophen + Cyproheptadine Major
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 Cyproheptadine with Mirtazapine?
MediHelp rates the interaction as moderate. Cyproheptadine 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 are strongly H1-blocking and sedating, so combining them can substantially increase drowsiness and impair performance. Mirtazapine's 5-HT2 antagonism overlaps with cyproheptadine's, and the pair adds little therapeutic benefit.
How serious is the interaction between Cyproheptadine 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 excessive sedation, especially at treatment start, and advise against driving. Reduce the dose or avoid the combination if daytime impairment occurs.
What other medicines interact with Cyproheptadine?
MediHelp also lists interactions of Cyproheptadine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Cyproheptadine page.
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