Drug interactions
Mirtazapine + Paliperidone
Severity: Moderate
Mirtazapine and Paliperidone: 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
Paliperidone prolongs the QT interval to a modest degree, and mirtazapine may add to this. The combination raises the risk of ventricular arrhythmia, especially with bradycardia, hypokalemia or renal impairment that raises paliperidone levels.
What this interaction means in plain words
Mirtazapine and Paliperidone 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; Paliperidone belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic QT prolongation.
What to do
Obtain a baseline ECG and electrolytes, and repeat the ECG after dose changes. Avoid further QT-prolonging drugs and limit paliperidone dose in renal impairment.
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
Other interactions of Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Mirtazapine with Paliperidone?
MediHelp rates the interaction as moderate. Mirtazapine and Paliperidone 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. Paliperidone prolongs the QT interval to a modest degree, and mirtazapine may add to this. The combination raises the risk of ventricular arrhythmia, especially with bradycardia, hypokalemia or renal impairment that raises paliperidone levels.
How serious is the interaction between Mirtazapine and Paliperidone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and electrolytes, and repeat the ECG after dose changes. Avoid further QT-prolonging drugs and limit paliperidone dose in renal impairment.
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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