Drug interactions
Mirtazapine + Ranolazine
Severity: Moderate
Mirtazapine and Ranolazine: 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 ranolazine also prolongs the QT interval. The combination may add modestly to arrhythmia risk.
What this interaction means in plain words
Mirtazapine and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic QT prolongation.
What to do
Obtain a baseline ECG in patients with cardiac disease or other QT risk factors and correct electrolyte abnormalities. Keep mirtazapine at the lowest effective dose.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine?
MediHelp rates the interaction as moderate. Mirtazapine and Ranolazine 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 ranolazine also prolongs the QT interval. The combination may add modestly to arrhythmia risk.
How serious is the interaction between Mirtazapine and Ranolazine?
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 in patients with cardiac disease or other QT risk factors and correct electrolyte abnormalities. Keep mirtazapine at the lowest effective dose.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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