Drug interactions
Mirtazapine + Same
Severity: Moderate
Mirtazapine and Same: 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
S-adenosylmethionine (SAMe) may enhance serotonergic activity, and mirtazapine also increases serotonergic and noradrenergic transmission. Combined use could contribute to serotonin toxicity, although reports are limited.
What this interaction means in plain words
Mirtazapine and Same 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.
Why it happens
Possible additive serotonergic effects; the mechanism for SAMe is not firmly established.
What to do
Monitor for agitation, tremor, sweating, hyperreflexia and diarrhea after starting or increasing either agent. Stop SAMe if serotonin toxicity symptoms occur.
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
Frequently asked questions
Can I take Mirtazapine with Same?
MediHelp rates the interaction as moderate. Mirtazapine and Same 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. S-adenosylmethionine (SAMe) may enhance serotonergic activity, and mirtazapine also increases serotonergic and noradrenergic transmission. Combined use could contribute to serotonin toxicity, although reports are limited.
How serious is the interaction between Mirtazapine and Same?
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 agitation, tremor, sweating, hyperreflexia and diarrhea after starting or increasing either agent. Stop SAMe if serotonin toxicity symptoms occur.
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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