Drug interactions
Methadone + Mirtazapine
Severity: Moderate
Methadone 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
Both agents can prolong the QTc interval, and mirtazapine adds sedation and a small serotonergic contribution. Together they may raise arrhythmia risk and cause excess sedation.
What this interaction means in plain words
Methadone 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.
Methadone belongs to Musculoskeletal; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, additive CNS depression and possible serotonergic effects.
What to do
Check a baseline ECG and monitor the QTc after changes. Watch for sedation and serotonin toxicity features.
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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
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 Methadone with Mirtazapine?
MediHelp rates the interaction as moderate. Methadone 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. Both agents can prolong the QTc interval, and mirtazapine adds sedation and a small serotonergic contribution. Together they may raise arrhythmia risk and cause excess sedation.
How serious is the interaction between Methadone 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: Check a baseline ECG and monitor the QTc after changes. Watch for sedation and serotonin toxicity features.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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