Drug interactions
Methylthioninium chloride + Mirtazapine
Severity: Major
Methylthioninium chloride 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
Mirtazapine enhances serotonergic and noradrenergic transmission, and combined with methylene blue's MAO-A inhibition it can cause serotonin syndrome. The risk is lower than with reuptake inhibitors but still clinically significant.
What this interaction means in plain words
Methylthioninium chloride 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.
Methylthioninium chloride belongs to Miscellaneous; Mirtazapine belongs to Central Nervous System.
Why it happens
MAO-A inhibition by methylene blue added to the serotonergic effects of mirtazapine.
What to do
Avoid where possible; if methylene blue is needed, hold mirtazapine and monitor for serotonin syndrome features.
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 Methylthioninium chloride
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 Methylthioninium chloride with Mirtazapine?
MediHelp rates the interaction as major. Methylthioninium chloride 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. Mirtazapine enhances serotonergic and noradrenergic transmission, and combined with methylene blue's MAO-A inhibition it can cause serotonin syndrome. The risk is lower than with reuptake inhibitors but still clinically significant.
How serious is the interaction between Methylthioninium chloride 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: Avoid where possible; if methylene blue is needed, hold mirtazapine and monitor for serotonin syndrome features.
What other medicines interact with Methylthioninium chloride?
MediHelp also lists interactions of Methylthioninium chloride with, for example, Levomilnacipran, Linezolid, Bupropion. The full list is on the Methylthioninium chloride page.
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