Drug interactions
Mirabegron + Pitolisant
Severity: Moderate
Mirabegron and Pitolisant: 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
Pitolisant is metabolized by CYP2D6 and CYP3A4, so CYP2D6 inhibition by mirabegron can raise pitolisant levels. This may increase QT prolongation risk and adverse effects such as insomnia, anxiety and nausea.
What this interaction means in plain words
Mirabegron and Pitolisant 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.
Mirabegron belongs to Genitourinary; Pitolisant belongs to Central Nervous System.
Why it happens
Mirabegron inhibits CYP2D6, decreasing pitolisant clearance.
What to do
Consider the labeled pitolisant dose reduction when CYP2D6 inhibitors are added, and monitor for adverse effects and QT prolongation in at-risk patients.
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 Mirabegron
- Digoxin + Mirabegron Major
- Flecainide + Mirabegron Major
- Mirabegron + Propafenone Major
- Mirabegron + Thioridazine Major
- Amitriptyline + Mirabegron Moderate
- Amoxapine + Mirabegron Moderate
Other interactions of Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Mirabegron with Pitolisant?
MediHelp rates the interaction as moderate. Mirabegron and Pitolisant 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. Pitolisant is metabolized by CYP2D6 and CYP3A4, so CYP2D6 inhibition by mirabegron can raise pitolisant levels. This may increase QT prolongation risk and adverse effects such as insomnia, anxiety and nausea.
How serious is the interaction between Mirabegron and Pitolisant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider the labeled pitolisant dose reduction when CYP2D6 inhibitors are added, and monitor for adverse effects and QT prolongation in at-risk patients.
What other medicines interact with Mirabegron?
MediHelp also lists interactions of Mirabegron with, for example, Digoxin, Flecainide, Propafenone. The full list is on the Mirabegron page.
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