Drug interactions
Erythromycin + Mirtazapine
Severity: Moderate
Erythromycin 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 may prolong the QT interval, so combined use can add to arrhythmia risk, particularly with other risk factors. Erythromycin may also modestly raise mirtazapine levels.
What this interaction means in plain words
Erythromycin 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.
Erythromycin belongs to Anti Bacterial; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, with possible CYP3A4 inhibition by erythromycin.
What to do
Check baseline ECG and electrolytes in patients with cardiac risk factors. Monitor for sedation and palpitations and consider an alternative antibiotic.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
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 Erythromycin with Mirtazapine?
MediHelp rates the interaction as moderate. Erythromycin 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 may prolong the QT interval, so combined use can add to arrhythmia risk, particularly with other risk factors. Erythromycin may also modestly raise mirtazapine levels.
How serious is the interaction between Erythromycin 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 baseline ECG and electrolytes in patients with cardiac risk factors. Monitor for sedation and palpitations and consider an alternative antibiotic.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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