Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Mirtazapine
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df 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
Cobicistat inhibits CYP3A4 and CYP2D6, which metabolize mirtazapine, so mirtazapine levels may increase. This can cause more sedation, and QT prolongation is possible.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df 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.
Why it happens
Cobicistat inhibits CYP3A4 and CYP2D6, reducing mirtazapine clearance.
What to do
Start mirtazapine at a low dose and titrate to response. Monitor for sedation and, in patients with QT risk factors, consider an ECG.
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
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Mirtazapine?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df 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. Cobicistat inhibits CYP3A4 and CYP2D6, which metabolize mirtazapine, so mirtazapine levels may increase. This can cause more sedation, and QT prolongation is possible.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df 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: Start mirtazapine at a low dose and titrate to response. Monitor for sedation and, in patients with QT risk factors, consider an ECG.
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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