Drug interactions
Mirtazapine + Tacrolimus
Severity: Moderate
Mirtazapine and Tacrolimus: 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
Both drugs have been associated with QT prolongation, so the combination may increase the risk of arrhythmia, particularly with electrolyte disturbances. Clinically significant events are uncommon and the risk is mainly in patients with additional risk factors.
What this interaction means in plain words
Mirtazapine and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT interval prolongation.
What to do
Obtain a baseline ECG and monitor it periodically, and keep potassium and magnesium within normal range. Avoid adding further QT-prolonging drugs where possible.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Mirtazapine with Tacrolimus?
MediHelp rates the interaction as moderate. Mirtazapine and Tacrolimus 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. Both drugs have been associated with QT prolongation, so the combination may increase the risk of arrhythmia, particularly with electrolyte disturbances. Clinically significant events are uncommon and the risk is mainly in patients with additional risk factors.
How serious is the interaction between Mirtazapine and Tacrolimus?
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 and monitor it periodically, and keep potassium and magnesium within normal range. Avoid adding further QT-prolonging drugs where possible.
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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