Drug interactions
Mirtazapine + Procarbazine
Severity: Contraindicated
Mirtazapine and Procarbazine: contraindicated 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
Procarbazine has weak monoamine oxidase inhibiting activity, and combining it with mirtazapine, which enhances serotonergic and noradrenergic transmission, may precipitate serotonin syndrome. Features include agitation, hyperthermia, clonus, tremor and autonomic instability.
What this interaction means in plain words
Mirtazapine and Procarbazine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Mirtazapine belongs to Central Nervous System; Procarbazine belongs to Oncology.
Why it happens
Additive serotonergic effect from MAO inhibition by procarbazine plus enhanced monoamine release by mirtazapine.
What to do
Avoid the combination and allow about 14 days after stopping procarbazine before starting mirtazapine, and a similar washout the other way round. Choose a non-serotonergic antidepressant or antiemetic if needed during procarbazine therapy.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mirtazapine and Procarbazine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
- Mirtazapine + Selegiline transdermal Contraindicated
Other interactions of Procarbazine
- Adenovirus types 4 and 7 live + Procarbazine Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amoxapine + Procarbazine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Bcg vaccine live + Procarbazine Contraindicated
- Brimonidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Mirtazapine with Procarbazine?
MediHelp rates the interaction as contraindicated. Mirtazapine and Procarbazine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Procarbazine has weak monoamine oxidase inhibiting activity, and combining it with mirtazapine, which enhances serotonergic and noradrenergic transmission, may precipitate serotonin syndrome. Features include agitation, hyperthermia, clonus, tremor and autonomic instability.
How serious is the interaction between Mirtazapine and Procarbazine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and allow about 14 days after stopping procarbazine before starting mirtazapine, and a similar washout the other way round. Choose a non-serotonergic antidepressant or antiemetic if needed during procarbazine therapy.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
