Drug interactions
Milnacipran + Mirtazapine
Severity: Moderate
Milnacipran 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
Combining milnacipran with mirtazapine may increase serotonergic activity, though the serotonin syndrome risk with mirtazapine is low. The pair can also add to blood pressure changes and sedation.
What this interaction means in plain words
Milnacipran 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.
Milnacipran belongs to Central Nervous System; Mirtazapine belongs to Central Nervous System.
Why it happens
Additive serotonergic and noradrenergic effects from reuptake inhibition and alpha-2 receptor antagonism.
What to do
Use the lowest effective doses and monitor for serotonin syndrome, sedation and blood pressure changes. Stop one or both agents if toxicity appears.
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 Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide 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 Milnacipran with Mirtazapine?
MediHelp rates the interaction as moderate. Milnacipran 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. Combining milnacipran with mirtazapine may increase serotonergic activity, though the serotonin syndrome risk with mirtazapine is low. The pair can also add to blood pressure changes and sedation.
How serious is the interaction between Milnacipran 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: Use the lowest effective doses and monitor for serotonin syndrome, sedation and blood pressure changes. Stop one or both agents if toxicity appears.
What other medicines interact with Milnacipran?
MediHelp also lists interactions of Milnacipran with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Milnacipran page.
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