Drug interactions
Hydroxyzine + Mirtazapine
Severity: Moderate
Hydroxyzine 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 agents are sedating antihistaminic drugs and both can prolong the QT interval. Together they may cause marked drowsiness and increase arrhythmia risk, particularly in older patients.
What this interaction means in plain words
Hydroxyzine 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.
Hydroxyzine belongs to Respiratory; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive H1 antagonism causing CNS depression, plus additive QT prolongation.
What to do
Use the lowest effective hydroxyzine dose for the shortest time and avoid it in patients with other QT risk factors. Monitor ECG and electrolytes in high-risk patients and warn about sedation.
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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Hydroxyzine with Mirtazapine?
MediHelp rates the interaction as moderate. Hydroxyzine 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 agents are sedating antihistaminic drugs and both can prolong the QT interval. Together they may cause marked drowsiness and increase arrhythmia risk, particularly in older patients.
How serious is the interaction between Hydroxyzine 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: Use the lowest effective hydroxyzine dose for the shortest time and avoid it in patients with other QT risk factors. Monitor ECG and electrolytes in high-risk patients and warn about sedation.
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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