Drug interactions
Mirtazapine + Voriconazole
Severity: Major
Mirtazapine and Voriconazole: major 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
Voriconazole may raise mirtazapine levels, and both drugs can prolong the QT interval. The combination could increase the risk of arrhythmia, particularly with other risk factors.
What this interaction means in plain words
Mirtazapine and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
CYP3A4 inhibition raising mirtazapine exposure, combined with additive QT prolongation.
What to do
Avoid if possible; if both are needed, obtain a baseline and follow-up ECG, correct electrolytes and consider reducing the mirtazapine dose.
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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Other interactions of Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole 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 Voriconazole?
MediHelp rates the interaction as major. Mirtazapine and Voriconazole 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. Voriconazole may raise mirtazapine levels, and both drugs can prolong the QT interval. The combination could increase the risk of arrhythmia, particularly with other risk factors.
How serious is the interaction between Mirtazapine and Voriconazole?
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 if possible; if both are needed, obtain a baseline and follow-up ECG, correct electrolytes and consider reducing the mirtazapine dose.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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