Drug interactions
Isocarboxazid + Mirtazapine
Severity: Contraindicated
Isocarboxazid and Mirtazapine: contraindicated 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
Combining mirtazapine with a nonselective MAO inhibitor can cause serotonin syndrome, with agitation, hyperthermia, clonus and autonomic instability. Mirtazapine labeling contraindicates use with MAOIs or within 14 days of stopping one.
What this interaction means in plain words
Isocarboxazid and Mirtazapine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Isocarboxazid belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Irreversible MAO inhibition raises monoamine levels, which adds to the noradrenergic and serotonergic effects of mirtazapine.
What to do
Do not coadminister. Allow at least 14 days after stopping isocarboxazid before starting mirtazapine, and 14 days after stopping mirtazapine before starting the MAOI.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Mirtazapine
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
- Mirtazapine + Selegiline transdermal Contraindicated
Other interactions of Isocarboxazid
- 5-HTP + Isocarboxazid Contraindicated
- Amitriptyline + Isocarboxazid Contraindicated
- Amobarbital + Isocarboxazid Contraindicated
- Amoxapine + Isocarboxazid Contraindicated
- Apraclonidine + Isocarboxazid Contraindicated
- Atomoxetine + Isocarboxazid Contraindicated
Frequently asked questions
Can I take Isocarboxazid with Mirtazapine?
MediHelp rates the interaction as contraindicated. Isocarboxazid and Mirtazapine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Combining mirtazapine with a nonselective MAO inhibitor can cause serotonin syndrome, with agitation, hyperthermia, clonus and autonomic instability. Mirtazapine labeling contraindicates use with MAOIs or within 14 days of stopping one.
How serious is the interaction between Isocarboxazid and Mirtazapine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister. Allow at least 14 days after stopping isocarboxazid before starting mirtazapine, and 14 days after stopping mirtazapine before starting the MAOI.
What other medicines interact with Mirtazapine?
MediHelp also lists interactions of Mirtazapine with, for example, Phenelzine, Pimozide, Procarbazine. The full list is on the Mirtazapine page.
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