Drug interactions
Mirtazapine + Nefazodone
Severity: Moderate
Mirtazapine and Nefazodone: 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
Nefazodone is a strong CYP3A4 inhibitor and can raise mirtazapine concentrations, increasing sedation, dizziness and other adverse effects. Both drugs also have serotonergic activity, adding a theoretical risk of serotonin toxicity.
What this interaction means in plain words
Mirtazapine and Nefazodone 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.
Why it happens
Inhibition of CYP3A4-mediated mirtazapine metabolism by nefazodone, with additive serotonergic effects.
What to do
Avoid combining two antidepressants where possible. If used together, start mirtazapine at a low dose and monitor for sedation and serotonin toxicity.
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
Frequently asked questions
Can I take Mirtazapine with Nefazodone?
MediHelp rates the interaction as moderate. Mirtazapine and Nefazodone 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. Nefazodone is a strong CYP3A4 inhibitor and can raise mirtazapine concentrations, increasing sedation, dizziness and other adverse effects. Both drugs also have serotonergic activity, adding a theoretical risk of serotonin toxicity.
How serious is the interaction between Mirtazapine and Nefazodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining two antidepressants where possible. If used together, start mirtazapine at a low dose and monitor for sedation and serotonin toxicity.
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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