Drug interactions
Lorlatinib + Mirtazapine
Severity: Moderate
Lorlatinib 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
Lorlatinib induces CYP3A4 and may lower mirtazapine exposure, which could reduce antidepressant efficacy. The effect is predicted rather than well characterized for this pair.
What this interaction means in plain words
Lorlatinib 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.
Lorlatinib belongs to Oncology; Mirtazapine belongs to Central Nervous System.
Why it happens
CYP3A4 induction by lorlatinib increases mirtazapine metabolism.
What to do
Monitor for loss of antidepressant response and titrate the mirtazapine dose upward if needed. Re-evaluate the dose if lorlatinib is stopped.
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 Lorlatinib
- Amobarbital + Lorlatinib Contraindicated
- Apalutamide + Lorlatinib Contraindicated
- Butabarbital + Lorlatinib Contraindicated
- Carbamazepine + Lorlatinib Contraindicated
- Enzalutamide + Lorlatinib Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
Frequently asked questions
Can I take Lorlatinib with Mirtazapine?
MediHelp rates the interaction as moderate. Lorlatinib 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. Lorlatinib induces CYP3A4 and may lower mirtazapine exposure, which could reduce antidepressant efficacy. The effect is predicted rather than well characterized for this pair.
How serious is the interaction between Lorlatinib 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: Monitor for loss of antidepressant response and titrate the mirtazapine dose upward if needed. Re-evaluate the dose if lorlatinib is stopped.
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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