Drug interactions
Flecainide + Mirtazapine
Severity: Moderate
Flecainide 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
Mirtazapine has been associated with QT prolongation, mainly in overdose or with other risk factors, and flecainide is proarrhythmic. The combined risk of ventricular arrhythmia is probably small at usual doses but is higher in susceptible patients.
What this interaction means in plain words
Flecainide 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.
Flecainide belongs to Cardiovascular; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive effects on cardiac repolarization.
What to do
Check a baseline ECG in patients with cardiac risk factors and correct potassium and magnesium. Avoid exceeding usual mirtazapine doses.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir 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 Flecainide with Mirtazapine?
MediHelp rates the interaction as moderate. Flecainide 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. Mirtazapine has been associated with QT prolongation, mainly in overdose or with other risk factors, and flecainide is proarrhythmic. The combined risk of ventricular arrhythmia is probably small at usual doses but is higher in susceptible patients.
How serious is the interaction between Flecainide 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 a baseline ECG in patients with cardiac risk factors and correct potassium and magnesium. Avoid exceeding usual mirtazapine doses.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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