Drug interactions
Mirtazapine + Propafenone
Severity: Moderate
Mirtazapine and Propafenone: 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
Mirtazapine has been associated with QT prolongation, mainly in overdose or with other risk factors, and propafenone has proarrhythmic effects. The combination may modestly raise the risk of ventricular arrhythmia. Propafenone may also raise mirtazapine levels through CYP2D6 inhibition.
What this interaction means in plain words
Mirtazapine and Propafenone 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; Propafenone belongs to Cardiovascular.
Why it happens
Additive QT and conduction effects, with possible CYP2D6 inhibition by propafenone raising mirtazapine exposure.
What to do
Check a baseline ECG and keep potassium and magnesium normal. Use the lowest effective mirtazapine dose and watch for sedation and palpitations.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone 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 Propafenone?
MediHelp rates the interaction as moderate. Mirtazapine and Propafenone 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 has been associated with QT prolongation, mainly in overdose or with other risk factors, and propafenone has proarrhythmic effects. The combination may modestly raise the risk of ventricular arrhythmia. Propafenone may also raise mirtazapine levels through CYP2D6 inhibition.
How serious is the interaction between Mirtazapine and Propafenone?
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 a baseline ECG and keep potassium and magnesium normal. Use the lowest effective mirtazapine dose and watch for sedation and palpitations.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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