Drug interactions
Dextromoramide + Mirtazapine
Severity: Major
Dextromoramide and Mirtazapine: major interaction.
Last updated Sources: UK SmPC
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
Dextromoramide is a potent opioid, and mirtazapine adds sedation, increasing the risk of profound CNS and respiratory depression. The risk is highest in opioid-naive, elderly or frail patients.
What this interaction means in plain words
Dextromoramide and Mirtazapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression from opioid agonism and sedating antidepressant activity.
What to do
Use the lowest effective opioid dose and monitor respiratory rate and sedation closely. Advise avoiding alcohol and other sedatives.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Dextromoramide with Mirtazapine?
MediHelp rates the interaction as major. Dextromoramide and Mirtazapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Dextromoramide is a potent opioid, and mirtazapine adds sedation, increasing the risk of profound CNS and respiratory depression. The risk is highest in opioid-naive, elderly or frail patients.
How serious is the interaction between Dextromoramide and Mirtazapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective opioid dose and monitor respiratory rate and sedation closely. Advise avoiding alcohol and other sedatives.
What other medicines interact with Mirtazapine?
MediHelp also lists interactions of Mirtazapine with, for example, Isocarboxazid, Phenelzine, Pimozide. The full list is on the Mirtazapine page.
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