Drug interactions
Mirtazapine + Olanzapine / samidorphan
Severity: Moderate
Mirtazapine and Olanzapine / samidorphan: 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 mirtazapine and olanzapine cause sedation and can lower blood pressure on standing. Combined use may increase drowsiness, dizziness, orthostatic hypotension and psychomotor impairment, raising the risk of falls, particularly in older patients.
What this interaction means in plain words
Mirtazapine and Olanzapine / samidorphan 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
Additive central nervous system depression and alpha-adrenergic and histamine H1 antagonism.
What to do
Monitor for sedation and orthostatic blood pressure changes, especially at initiation and after dose increases. Counsel patients to rise slowly and avoid driving until response is known.
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 Olanzapine / samidorphan?
MediHelp rates the interaction as moderate. Mirtazapine and Olanzapine / samidorphan 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 mirtazapine and olanzapine cause sedation and can lower blood pressure on standing. Combined use may increase drowsiness, dizziness, orthostatic hypotension and psychomotor impairment, raising the risk of falls, particularly in older patients.
How serious is the interaction between Mirtazapine and Olanzapine / samidorphan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation and orthostatic blood pressure changes, especially at initiation and after dose increases. Counsel patients to rise slowly and avoid driving until response is known.
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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