Drug interactions
Disopyramide + Mirtazapine
Severity: Major
Disopyramide 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
Disopyramide is a class Ia antiarrhythmic that prolongs the QT interval and can cause torsades de pointes. Mirtazapine may add to this effect, and both have anticholinergic or sedative properties.
What this interaction means in plain words
Disopyramide 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.
Disopyramide belongs to Cardiovascular; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive prolongation of cardiac repolarization (QT interval).
What to do
Avoid if possible or choose a non-QT-prolonging antidepressant. If combined, monitor ECG and electrolytes.
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
- Mirtazapine 15 mg film-coated tablets - SmPC sections 4.3/4.5 (class statement: medicines which prolong the QTc interval; "The risk of QT prolongation and/or ventricular arrhythmias (e.g. Torsades de Pointes) may be increased with concomitant use of medicines which prolong the QTc i") — electronic medicines compendium (UK SmPC)
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 Disopyramide
- Amisulpride + Disopyramide Contraindicated
- Desipramine + Disopyramide Contraindicated
- Disopyramide + Dronedarone Contraindicated
- Disopyramide + Itraconazole Contraindicated
- Disopyramide + Ketoconazole Contraindicated
- Disopyramide + Maprotiline Contraindicated
Frequently asked questions
Can I take Disopyramide with Mirtazapine?
MediHelp rates the interaction as major. Disopyramide 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. Disopyramide is a class Ia antiarrhythmic that prolongs the QT interval and can cause torsades de pointes. Mirtazapine may add to this effect, and both have anticholinergic or sedative properties.
How serious is the interaction between Disopyramide 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: Avoid if possible or choose a non-QT-prolonging antidepressant. If combined, monitor ECG and electrolytes.
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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