Drug interactions
Dihydroergotamine + Mirtazapine
Severity: Moderate
Dihydroergotamine 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 have serotonergic activity, so combined use could in theory contribute to serotonin toxicity. Clinical reports are scarce, and dihydroergotamine's main hazards come from CYP3A4 inhibitors, not from mirtazapine.
What this interaction means in plain words
Dihydroergotamine 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.
Dihydroergotamine belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects: mirtazapine enhances serotonin and noradrenaline transmission, and dihydroergotamine is an agonist at 5-HT1 receptors.
What to do
Monitor for agitation, tremor, hyperthermia, diarrhea and neuromuscular hyperactivity after starting or increasing either drug. Stop the serotonergic agents 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 Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Other interactions of Dihydroergotamine
- Almotriptan + Dihydroergotamine Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
- Dihydroergotamine + Dopamine Contraindicated
- Dihydroergotamine + Dronedarone Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Dihydroergotamine + Eletriptan Contraindicated
Frequently asked questions
Can I take Dihydroergotamine with Mirtazapine?
MediHelp rates the interaction as moderate. Dihydroergotamine 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 have serotonergic activity, so combined use could in theory contribute to serotonin toxicity. Clinical reports are scarce, and dihydroergotamine's main hazards come from CYP3A4 inhibitors, not from mirtazapine.
How serious is the interaction between Dihydroergotamine 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, hyperthermia, diarrhea and neuromuscular hyperactivity after starting or increasing either drug. Stop the serotonergic agents if serotonin syndrome is suspected.
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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