Drug interactions
Levorphanol + Mirtazapine
Severity: Major
Levorphanol 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
Both agents depress the central nervous system. Combined use can cause additive sedation, impaired psychomotor function and respiratory depression, which can be dangerous in higher-risk patients.
What this interaction means in plain words
Levorphanol 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.
Why it happens
Additive CNS and respiratory depression from opioid activity and mirtazapine's sedative antihistaminic effects.
What to do
Use the lowest effective doses and monitor for sedation and respiratory depression, especially at initiation and dose increases. Counsel patients to avoid alcohol and other sedatives.
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
Frequently asked questions
Can I take Levorphanol with Mirtazapine?
MediHelp rates the interaction as major. Levorphanol 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. Both agents depress the central nervous system. Combined use can cause additive sedation, impaired psychomotor function and respiratory depression, which can be dangerous in higher-risk patients.
How serious is the interaction between Levorphanol 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: Use the lowest effective doses and monitor for sedation and respiratory depression, especially at initiation and dose increases. Counsel patients to avoid alcohol and other sedatives.
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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