Drug interactions
Mirtazapine + Venlafaxine
Severity: Moderate
Mirtazapine and Venlafaxine: 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
The combination is used in practice for resistant depression, but both drugs have serotonergic activity and can contribute to serotonin syndrome. Both also have minor QT-prolonging potential, especially at high doses or overdose.
What this interaction means in plain words
Mirtazapine and Venlafaxine 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; Venlafaxine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects and a small additive effect on QT interval.
What to do
Start with low doses and titrate gradually, monitoring for serotonin toxicity symptoms. Obtain an ECG if other QT risk factors are present.
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 Venlafaxine
- Isocarboxazid + Venlafaxine Contraindicated
- Methylene blue + Venlafaxine Contraindicated
- Phenelzine + Venlafaxine Contraindicated
- Procarbazine + Venlafaxine Contraindicated
- Rasagiline + Venlafaxine Contraindicated
- Safinamide + Venlafaxine Contraindicated
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 Venlafaxine?
MediHelp rates the interaction as moderate. Mirtazapine and Venlafaxine 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. The combination is used in practice for resistant depression, but both drugs have serotonergic activity and can contribute to serotonin syndrome. Both also have minor QT-prolonging potential, especially at high doses or overdose.
How serious is the interaction between Mirtazapine and Venlafaxine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and titrate gradually, monitoring for serotonin toxicity symptoms. Obtain an ECG if other QT risk factors are present.
What other medicines interact with Venlafaxine?
MediHelp also lists interactions of Venlafaxine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Venlafaxine page.
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