Drug interactions
Dextromethorphan + Mirtazapine
Severity: Moderate
Dextromethorphan 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 enhance serotonergic signalling, so combined use may rarely lead to serotonin syndrome. The risk appears low at usual doses.
What this interaction means in plain words
Dextromethorphan 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.
Dextromethorphan belongs to Respiratory; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from dextromethorphan reuptake inhibition and mirtazapine noradrenergic and serotonergic modulation.
What to do
Monitor for agitation, tremor, sweating and hyperreflexia after starting or increasing doses. Keep dextromethorphan at standard doses.
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 Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + 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 Dextromethorphan with Mirtazapine?
MediHelp rates the interaction as moderate. Dextromethorphan 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 enhance serotonergic signalling, so combined use may rarely lead to serotonin syndrome. The risk appears low at usual doses.
How serious is the interaction between Dextromethorphan 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 agitation, tremor, sweating and hyperreflexia after starting or increasing doses. Keep dextromethorphan at standard doses.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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