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Drug interactions

Mirtazapine + Selpercatinib

Severity: Major

Mirtazapine and Selpercatinib: 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

Selpercatinib can prolong the QT interval, and mirtazapine may contribute additional QT effect. This increases the risk of ventricular arrhythmias.

What this interaction means in plain words

Mirtazapine and Selpercatinib 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; Selpercatinib belongs to Oncology.

Evidence level: Moderate

Why it happens

Additive pharmacodynamic QT prolongation.

What to do

Monitor ECG and electrolytes at baseline and during treatment, and correct abnormalities. Consider an alternative antidepressant if QTc becomes prolonged.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Mirtazapine with Selpercatinib?

MediHelp rates the interaction as major. Mirtazapine and Selpercatinib 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. Selpercatinib can prolong the QT interval, and mirtazapine may contribute additional QT effect. This increases the risk of ventricular arrhythmias.

How serious is the interaction between Mirtazapine and Selpercatinib?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and electrolytes at baseline and during treatment, and correct abnormalities. Consider an alternative antidepressant if QTc becomes prolonged.

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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