Drug interactions
Mirtazapine + Nilotinib
Severity: Major
Mirtazapine and Nilotinib: major interaction.
Last updated Sources: US FDA label
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
Nilotinib carries a boxed warning for QT prolongation and sudden death. Adding mirtazapine, which may also lengthen the QT interval, can raise the risk of torsades de pointes.
What this interaction means in plain words
Mirtazapine and Nilotinib 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 belongs to Central Nervous System; Nilotinib belongs to Oncology.
Why it happens
Additive QT prolongation; nilotinib is also a CYP3A4 substrate and inhibitor, which may affect mirtazapine exposure.
What to do
Avoid if possible and choose an antidepressant with less QT effect. If it is unavoidable, monitor ECG at baseline and regularly, and keep potassium and magnesium in the normal range.
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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References
Other interactions of Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Other interactions of Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Frequently asked questions
Can I take Mirtazapine with Nilotinib?
MediHelp rates the interaction as major. Mirtazapine and Nilotinib 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. Nilotinib carries a boxed warning for QT prolongation and sudden death. Adding mirtazapine, which may also lengthen the QT interval, can raise the risk of torsades de pointes.
How serious is the interaction between Mirtazapine and Nilotinib?
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 if possible and choose an antidepressant with less QT effect. If it is unavoidable, monitor ECG at baseline and regularly, and keep potassium and magnesium in the normal range.
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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