Drug interactions
Mirtazapine + Nortriptyline
Severity: Moderate
Mirtazapine and Nortriptyline: 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
Both drugs have some QT-prolonging potential and are sedating, so combined use may add to arrhythmia risk and CNS depression. Serotonergic effects are also possible, although the combination is used in practice.
What this interaction means in plain words
Mirtazapine and Nortriptyline 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.
Mirtazapine belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, sedation and serotonergic activity.
What to do
Check ECG and electrolytes in patients with cardiac risk factors, and monitor for sedation and serotonergic symptoms.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline 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 Mirtazapine with Nortriptyline?
MediHelp rates the interaction as moderate. Mirtazapine and Nortriptyline 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. Both drugs have some QT-prolonging potential and are sedating, so combined use may add to arrhythmia risk and CNS depression. Serotonergic effects are also possible, although the combination is used in practice.
How serious is the interaction between Mirtazapine and Nortriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check ECG and electrolytes in patients with cardiac risk factors, and monitor for sedation and serotonergic symptoms.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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