Drug interactions
Desvenlafaxine + Mirtazapine
Severity: Moderate
Desvenlafaxine 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
Combining an SNRI with mirtazapine is used in practice for resistant depression but carries a risk of serotonin syndrome. Risk is greatest after dose increases or with additional serotonergic drugs.
What this interaction means in plain words
Desvenlafaxine 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.
Desvenlafaxine belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive serotonergic activity from reuptake inhibition plus enhanced serotonin release and 5-HT1A stimulation via alpha-2 antagonism.
What to do
Use the lowest effective doses and titrate slowly while monitoring for agitation, tremor, hyperreflexia and hyperthermia. Stop one drug if serotonin syndrome is suspected.
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 Desvenlafaxine
- Desvenlafaxine + Isocarboxazid Contraindicated
- Desvenlafaxine + Methylene blue Contraindicated
- Desvenlafaxine + Phenelzine Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
- Desvenlafaxine + Safinamide Contraindicated
- Desvenlafaxine + Selegiline 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 Desvenlafaxine with Mirtazapine?
MediHelp rates the interaction as moderate. Desvenlafaxine 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. Combining an SNRI with mirtazapine is used in practice for resistant depression but carries a risk of serotonin syndrome. Risk is greatest after dose increases or with additional serotonergic drugs.
How serious is the interaction between Desvenlafaxine 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 titrate slowly while monitoring for agitation, tremor, hyperreflexia and hyperthermia. Stop one drug if serotonin syndrome is suspected.
What other medicines interact with Desvenlafaxine?
MediHelp also lists interactions of Desvenlafaxine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Desvenlafaxine page.
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