Drug interactions
Mirtazapine + Ribociclib
Severity: Major
Mirtazapine and Ribociclib: 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
Ribociclib causes dose-dependent QT prolongation, and its labeling advises avoiding other QT-prolonging drugs. Adding mirtazapine may further increase the risk of torsades de pointes.
What this interaction means in plain words
Mirtazapine and Ribociclib 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; Ribociclib belongs to Oncology.
Why it happens
Additive QT prolongation.
What to do
Avoid if possible and select an antidepressant with less QT effect. If the combination is needed, monitor ECG and electrolytes at baseline, around day 14 of cycle 1, and as clinically indicated.
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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Frequently asked questions
Can I take Mirtazapine with Ribociclib?
MediHelp rates the interaction as major. Mirtazapine and Ribociclib 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. Ribociclib causes dose-dependent QT prolongation, and its labeling advises avoiding other QT-prolonging drugs. Adding mirtazapine may further increase the risk of torsades de pointes.
How serious is the interaction between Mirtazapine and Ribociclib?
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 if possible and select an antidepressant with less QT effect. If the combination is needed, monitor ECG and electrolytes at baseline, around day 14 of cycle 1, and as clinically indicated.
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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