Drug interactions
Gepirone + Mirtazapine
Severity: Major
Gepirone 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
Gepirone is a 5-HT1A agonist antidepressant, and combining it with mirtazapine increases serotonergic load. This raises the risk of serotonin syndrome, and gepirone also carries a QT prolongation warning.
What this interaction means in plain words
Gepirone 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.
Gepirone belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from 5-HT1A agonism and mirtazapine's monoaminergic actions.
What to do
Avoid the combination where feasible, and if used, monitor for serotonin syndrome and QTc changes. Discontinue one or both drugs if symptoms develop.
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
Other interactions of Gepirone
- Clarithromycin + Gepirone Contraindicated
- Gepirone + Isocarboxazid Contraindicated
- Gepirone + Itraconazole Contraindicated
- Gepirone + Ketoconazole Contraindicated
- Gepirone + Linezolid Contraindicated
- Gepirone + Phenelzine Contraindicated
Frequently asked questions
Can I take Gepirone with Mirtazapine?
MediHelp rates the interaction as major. Gepirone 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. Gepirone is a 5-HT1A agonist antidepressant, and combining it with mirtazapine increases serotonergic load. This raises the risk of serotonin syndrome, and gepirone also carries a QT prolongation warning.
How serious is the interaction between Gepirone 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 feasible, and if used, monitor for serotonin syndrome and QTc changes. Discontinue one or both drugs if symptoms develop.
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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