Drug interactions
Mirtazapine + Rifabutin
Severity: Moderate
Mirtazapine and Rifabutin: 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
Rifabutin induces CYP3A4 and may lower mirtazapine concentrations, potentially reducing antidepressant effect. The induction by rifabutin is weaker than with rifampicin, so the effect is usually modest.
What this interaction means in plain words
Mirtazapine and Rifabutin 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; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces CYP3A4, increasing the metabolism of mirtazapine.
What to do
Monitor for loss of antidepressant response and increase the mirtazapine dose if needed. Reassess the dose when rifabutin is stopped.
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 Mirtazapine
- Isocarboxazid + Mirtazapine Contraindicated
- Mirtazapine + Phenelzine Contraindicated
- Mirtazapine + Pimozide Contraindicated
- Mirtazapine + Procarbazine Contraindicated
- Mirtazapine + Rasagiline Contraindicated
- Mirtazapine + Selegiline Contraindicated
Other interactions of Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Mirtazapine with Rifabutin?
MediHelp rates the interaction as moderate. Mirtazapine and Rifabutin 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. Rifabutin induces CYP3A4 and may lower mirtazapine concentrations, potentially reducing antidepressant effect. The induction by rifabutin is weaker than with rifampicin, so the effect is usually modest.
How serious is the interaction between Mirtazapine and Rifabutin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of antidepressant response and increase the mirtazapine dose if needed. Reassess the dose when rifabutin is stopped.
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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