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Drug interactions

Ibutilide + Mirtazapine

Severity: Major

Ibutilide 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

Ibutilide markedly prolongs the QT interval and carries a substantial risk of torsades de pointes. Mirtazapine adds further QT risk.

What this interaction means in plain words

Ibutilide 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.

Ibutilide belongs to Cardiovascular; Mirtazapine belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive prolongation of cardiac repolarization.

What to do

Avoid giving ibutilide to patients on mirtazapine unless no alternative exists. If used, provide continuous ECG monitoring during and after infusion with correction of electrolytes.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Ibutilide with Mirtazapine?

MediHelp rates the interaction as major. Ibutilide 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. Ibutilide markedly prolongs the QT interval and carries a substantial risk of torsades de pointes. Mirtazapine adds further QT risk.

How serious is the interaction between Ibutilide 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 giving ibutilide to patients on mirtazapine unless no alternative exists. If used, provide continuous ECG monitoring during and after infusion with correction of electrolytes.

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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