Drug interactions
Hydrocodone + Mirtazapine
Severity: Moderate
Hydrocodone 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 serotonergic activity, and combining them may raise the risk of serotonin syndrome, with agitation, tremor, hyperthermia and neuromuscular excitability. Additive sedation and CNS depression can also occur.
What this interaction means in plain words
Hydrocodone 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.
Hydrocodone belongs to Musculoskeletal; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects (opioid plus mirtazapine) and additive CNS depression.
What to do
Monitor for serotonin toxicity and excess sedation, especially at initiation and after dose changes. Use the lowest effective doses and stop one agent if symptoms emerge.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrocodone and Mirtazapine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
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 Hydrocodone with Mirtazapine?
MediHelp rates the interaction as moderate. Hydrocodone 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 serotonergic activity, and combining them may raise the risk of serotonin syndrome, with agitation, tremor, hyperthermia and neuromuscular excitability. Additive sedation and CNS depression can also occur.
How serious is the interaction between Hydrocodone 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: Monitor for serotonin toxicity and excess sedation, especially at initiation and after dose changes. Use the lowest effective doses and stop one agent if symptoms emerge.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
