Drug interactions
Mirtazapine + Vilazodone
Severity: Major
Mirtazapine and Vilazodone: 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
Both drugs enhance serotonergic neurotransmission, so combined use can cause serotonin syndrome, with agitation, tremor, clonus, hyperthermia and autonomic instability. Risk is greatest at initiation or after dose increases.
What this interaction means in plain words
Mirtazapine and Vilazodone 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; Vilazodone belongs to Central Nervous System.
Why it happens
Additive serotonergic effects: vilazodone inhibits serotonin reuptake and is a 5-HT1A partial agonist, while mirtazapine increases serotonin and noradrenaline release.
What to do
Avoid the combination if possible. If it is used, start low, titrate slowly, and monitor for serotonin syndrome, stopping both drugs and giving supportive care if it occurs.
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?
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References
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 Vilazodone
- Isocarboxazid + Vilazodone Contraindicated
- Methylene blue + Vilazodone Contraindicated
- Phenelzine + Vilazodone Contraindicated
- Rasagiline + Vilazodone Contraindicated
- Selegiline transdermal + Vilazodone Contraindicated
- Selegiline + Vilazodone Contraindicated
Frequently asked questions
Can I take Mirtazapine with Vilazodone?
MediHelp rates the interaction as major. Mirtazapine and Vilazodone 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. Both drugs enhance serotonergic neurotransmission, so combined use can cause serotonin syndrome, with agitation, tremor, clonus, hyperthermia and autonomic instability. Risk is greatest at initiation or after dose increases.
How serious is the interaction between Mirtazapine and Vilazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible. If it is used, start low, titrate slowly, and monitor for serotonin syndrome, stopping both drugs and giving supportive care if it occurs.
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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