Drug interactions
Lopinavir + Mirtazapine
Severity: Moderate
Lopinavir 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
Lopinavir/ritonavir can prolong QT and PR intervals, and mirtazapine adds QT risk. Ritonavir also inhibits CYP3A4 and may raise mirtazapine concentrations.
What this interaction means in plain words
Lopinavir 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.
Lopinavir belongs to Anti Virals; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by ritonavir increasing mirtazapine exposure.
What to do
Obtain a baseline ECG, correct electrolytes, and monitor QTc and sedation. Reduce the mirtazapine dose if adverse effects occur.
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 Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Lopinavir with Mirtazapine?
MediHelp rates the interaction as moderate. Lopinavir 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. Lopinavir/ritonavir can prolong QT and PR intervals, and mirtazapine adds QT risk. Ritonavir also inhibits CYP3A4 and may raise mirtazapine concentrations.
How serious is the interaction between Lopinavir 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: Obtain a baseline ECG, correct electrolytes, and monitor QTc and sedation. Reduce the mirtazapine dose if adverse effects occur.
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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