Drug interactions
Fluconazole + Mirtazapine
Severity: Moderate
Fluconazole 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 have been associated with QT interval prolongation, so combined use may add to the risk of torsades de pointes, particularly with other risk factors. Fluconazole may also modestly raise mirtazapine exposure through CYP3A4 inhibition.
What this interaction means in plain words
Fluconazole 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.
Fluconazole belongs to Anti Fungals; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive effects on cardiac repolarization plus fluconazole inhibition of CYP3A4-mediated mirtazapine metabolism.
What to do
Obtain a baseline ECG and correct potassium and magnesium before combining, and monitor QTc during therapy. Choose an alternative if the patient has congenital long QT or other QT-prolonging drugs.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole 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 Fluconazole with Mirtazapine?
MediHelp rates the interaction as moderate. Fluconazole 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 have been associated with QT interval prolongation, so combined use may add to the risk of torsades de pointes, particularly with other risk factors. Fluconazole may also modestly raise mirtazapine exposure through CYP3A4 inhibition.
How serious is the interaction between Fluconazole 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 correct potassium and magnesium before combining, and monitor QTc during therapy. Choose an alternative if the patient has congenital long QT or other QT-prolonging drugs.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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