Drug interactions
Donepezil + Mirtazapine
Severity: Moderate
Donepezil 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
Donepezil is associated with QT prolongation and torsades de pointes, and mirtazapine has been linked to QT prolongation as well. The combination may add to arrhythmic risk, particularly in older patients with bradycardia, heart disease or electrolyte disturbance.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation; donepezil may also cause bradycardia, increasing torsades risk.
What to do
Check ECG if there are risk factors and monitor for syncope or palpitations. Correct potassium and magnesium abnormalities and avoid additional QT-prolonging drugs.
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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Donepezil with Mirtazapine?
MediHelp rates the interaction as moderate. Donepezil 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. Donepezil is associated with QT prolongation and torsades de pointes, and mirtazapine has been linked to QT prolongation as well. The combination may add to arrhythmic risk, particularly in older patients with bradycardia, heart disease or electrolyte disturbance.
How serious is the interaction between Donepezil 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: Check ECG if there are risk factors and monitor for syncope or palpitations. Correct potassium and magnesium abnormalities and avoid additional QT-prolonging drugs.
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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