Drug interactions
Mirtazapine + Pitolisant
Severity: Major
Mirtazapine and Pitolisant: 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
Mirtazapine is a centrally acting H1 antagonist and may counteract the histamine-mediated wake-promoting effect of pitolisant. Both drugs can also prolong the QTc interval.
What this interaction means in plain words
Mirtazapine and Pitolisant 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; Pitolisant belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism at central H1 receptors plus additive QT prolongation.
What to do
Avoid the combination where possible, as pitolisant may lose efficacy. If used together, monitor ECG and assess control of sleepiness.
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 Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Mirtazapine with Pitolisant?
MediHelp rates the interaction as major. Mirtazapine and Pitolisant 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 is a centrally acting H1 antagonist and may counteract the histamine-mediated wake-promoting effect of pitolisant. Both drugs can also prolong the QTc interval.
How serious is the interaction between Mirtazapine and Pitolisant?
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 the combination where possible, as pitolisant may lose efficacy. If used together, monitor ECG and assess control of sleepiness.
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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