Drug interactions
Fingolimod + Mirtazapine
Severity: Moderate
Fingolimod 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 can prolong the QT interval, and fingolimod also causes bradycardia after the first dose. Together they may raise the risk of torsades de pointes, particularly in patients with other risk factors.
What this interaction means in plain words
Fingolimod 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.
Fingolimod belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic QT prolongation, with fingolimod-related bradycardia adding to arrhythmia risk.
What to do
Obtain a baseline ECG and monitor it during fingolimod initiation, and correct potassium and magnesium. Consider an alternative antidepressant if the QTc becomes markedly prolonged.
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 Fingolimod
- Adenovirus types 4 and 7 live + Fingolimod Contraindicated
- Bcg vaccine live + Fingolimod Contraindicated
- Fingolimod + Pimozide Contraindicated
- Fingolimod + Ponesimod Contraindicated
- Fingolimod + Quinidine Contraindicated
- Fingolimod + Siponimod Contraindicated
Frequently asked questions
Can I take Fingolimod with Mirtazapine?
MediHelp rates the interaction as moderate. Fingolimod 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 can prolong the QT interval, and fingolimod also causes bradycardia after the first dose. Together they may raise the risk of torsades de pointes, particularly in patients with other risk factors.
How serious is the interaction between Fingolimod 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: Obtain a baseline ECG and monitor it during fingolimod initiation, and correct potassium and magnesium. Consider an alternative antidepressant if the QTc becomes markedly prolonged.
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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