Drug interactions
Fexinidazole + Mirtazapine
Severity: Major
Fexinidazole and Mirtazapine: major 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
Fexinidazole can prolong the QT interval, and mirtazapine has additional QT liability, raising the risk of torsades de pointes. Fexinidazole may also inhibit CYP3A4 and increase mirtazapine exposure.
What this interaction means in plain words
Fexinidazole 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.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by fexinidazole raising mirtazapine levels.
What to do
Avoid the combination where possible, for example by holding mirtazapine during fexinidazole treatment. If unavoidable, monitor ECG and electrolytes and watch for excess sedation.
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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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 Fexinidazole with Mirtazapine?
MediHelp rates the interaction as major. Fexinidazole 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. Fexinidazole can prolong the QT interval, and mirtazapine has additional QT liability, raising the risk of torsades de pointes. Fexinidazole may also inhibit CYP3A4 and increase mirtazapine exposure.
How serious is the interaction between Fexinidazole 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 the combination where possible, for example by holding mirtazapine during fexinidazole treatment. If unavoidable, monitor ECG and electrolytes and watch for excess sedation.
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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