Closely (1)acrivastine and mirtazapine both increase sedation. Use Caution/Monitor.albuterolMonitor Closely (2)albuterol and mirtazapine both increase QTc interval. Use Caution/Monitor. mirtazapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilMonitor Closely (1)alfentanil and mirtazapine both increase sedation. Use Caution/Monitor.alfuzosinMonitor Closely (1)alfuzosin and mirtazapine both increase QTc interval. Use Caution/Monitor.almotriptanMonitor Closely (1)almotriptan and mirtazapine both increase serotonin levels. Use Caution/Monitor.alprazolamMonitor Closely (1)alprazolam and mirtazapine both increase sedation. Use Caution/Monitor.amiodaroneSerious - Use Alternative (1)mirtazapine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amisulprideSerious - Use Alternative (1)amisulpride and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylineMonitor Closely (2)amitriptyline and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. amitriptyline and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.amobarbitalMonitor Closely (1)amobarbital and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)amobarbital will decrease the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.amoxapineMonitor Closely (2)amoxapine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. amoxapine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.anagrelideSerious - Use Alternative (1)mirtazapine and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.anastrozoleMinor (1)anastrozole will increase the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.apalutamideSerious - Use Alternative (1)apalutamide will decrease the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.apomorphineMonitor Closely (1)apomorphine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)apomorphine and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.arformoterolMonitor Closely (2)mirtazapine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. arformoterol and mirtazapine both increase QTc interval. Use Caution/Monitor.aripiprazoleMonitor Closely (2)aripiprazole and mirtazapine both increase sedation. Use Caution/Monitor. aripiprazole and mirtazapine both increase QTc interval. Use Caution/Monitor.armodafinilMonitor Closely (1)mirtazapine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arsenic trioxideSerious - Use Alternative (1)mirtazapine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherSerious - Use Alternative (1)artemether and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineSerious - Use Alternative (1)artemether/lumefantrine and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.asenapineMonitor Closely (1)asenapine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and asenapine both increase QTc interval. Avoid or Use Alternate Drug.asenapine transdermalMonitor Closely (1)asenapine transdermal and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.atogepantMonitor Closely (1)mirtazapine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetineMonitor Closely (1)atomoxetine and mirtazapine both decrease QTc interval. Use Caution/Monitor.avapritinibMonitor Closely (2)mirtazapine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. avapritinib and mirtazapine both increase sedation. Use Caution/Monitor.axitinibMonitor Closely (1)mirtazapine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and mirtazapine both increase sedation. Use Caution/Monitor.azithromycinSerious - Use Alternative (1)mirtazapine and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.baclofenMonitor Closely (1)baclofen and mirtazapine both increase sedation. Use Caution/Monitor.bedaquilineSerious - Use Alternative (1)bedaquiline and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.belladonna and opiumMonitor Closely (1)belladonna and opium and mirtazapine both increase sedation. Use Caution/Monitor.benperidolMonitor Closely (1)benperidol and mirtazapine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/acetaminophen, mirtazapine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.Serious - Use Alternative (1)benzhydrocodone/acetaminophen and mirtazapine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetamineMonitor Closely (1)mirtazapine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.bosentanMonitor Closely (1)bosentan will decrease the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.brexanoloneMonitor Closely (1)brexanolone, mirtazapine. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazoleMonitor Closely (1)brexpiprazole and mirtazapine both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and mirtazapine both increase sedation. Use Caution/Monitor.brivaracetamMonitor Closely (1)brivaracetam and mirtazapine both increase sedation. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine and mirtazapine both increase sedation. Use Caution/Monitor.buprenorphineMonitor Closely (1)buprenorphine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantMonitor Closely (1)mirtazapine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.Serious - Use Alternative (2)buprenorphine subdermal implant and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine subdermal implant and mirtazapine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine transdermalSerious - Use Alternative (2)buprenorphine transdermal and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine transdermal and mirtazapine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine, long-acting injectionMonitor Closely (1)mirtazapine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.Serious - Use Alternative (2)buprenorphine, long-acting injection and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine, long-acting injection and mirtazapine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebupropionMonitor Closely (1)bupropion will increase the level or effect of mirtazapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.buspironeMonitor Closely (1)buspirone and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.butabarbitalMonitor Closely (1)butabarbital and mirtazapine both increase sedation. Use Caution/Monitor.butalbitalMonitor Closely (1)butalbital and mirtazapine both increase sedation. Use Caution/Monitor.butorphanolMonitor Closely (1)butorphanol and mirtazapine both increase sedation. Use Caution/Monitor.caffeineMonitor Closely (1)mirtazapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)mirtazapine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.cannabidiolMonitor Closely (1)cannabidiol, mirtazapine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.carbamazepineMonitor Closely (1)carbamazepine will decrease the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbinoxamineMonitor Closely (1)carbinoxamine and mirtazapine both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and mirtazapine both increase sedation. Use Caution/Monitor.cenobamateMonitor Closely (1)cenobamate will decrease the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.ceritinibSerious - Use Alternative (2)ceritinib and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug. ceritinib will increase the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chloral hydrateMonitor Closely (1)chloral hydrate and mirtazapine both increase sedation. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and mirtazapine both increase sedation. Use Caution/Monitor.chloroquineSerious - Use Alternative (1)chloroquine and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.chlorpheniramineMonitor Closely (1)chlorpheniramine and mirtazapine both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (1)chlorpromazine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.chlorzoxazoneMonitor Closely (1)chlorzoxazone and mirtazapine both increase sedation. Use Caution/Monitor.cinnarizineMonitor Closely (1)cinnarizine and mirtazapine both increase sedation. Use Caution/Monitor.ciprofloxacinSerious - Use Alternative (1)mirtazapine and ciprofloxacin both increase QTc interval. Avoid or Use Alternate Drug.citalopramMonitor Closely (1)citalopram and mirtazapine both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.Serious - Use Alternative (1)citalopram and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinSerious - Use Alternative (2)clarithromycin will increase the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. clarithromycin and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.clemastineMonitor Closely (1)clemastine and mirtazapine both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (2)clobazam will increase the level or effect of mirtazapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly. mirtazapine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clofazimineMonitor Closely (1)mirtazapine and clofazimine both increase QTc interval. Use Caution/Monitor.clomipramineMonitor Closely (2)clomipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. clomipramine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.clonazepamMonitor Closely (1)clonazepam and mirtazapine both increase sedation. Use Caution/Monitor.clonidineSerious - Use Alternative (1)mirtazapine decreases effects of clonidine by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of hypertensive urgency.clorazepateMonitor Closely (1)clorazepate and mirtazapine both increase sedation. Use Caution/Monitor.clozapineMonitor Closely (2)clozapine and mirtazapine both increase QTc interval. Use Caution/Monitor. clozapine and mirtazapine both increase sedation. Use Caution/Monitor.cobicistatMonitor Closely (1)cobicistat will increase the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cocaine topicalMonitor Closely (1)cocaine topical and mirtazapine both increase serotonin levels. Use Caution/Monitor.codeineMonitor Closely (1)codeine and mirtazapine both increase sedation. Use Caution/Monitor.crizotinibMonitor Closely (1)crizotinib increases levels of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.Serious - Use Alternative (1)crizotinib and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.crofelemerMonitor Closely (1)crofelemer increases levels of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.cyclizineMonitor Closely (1)cyclizine and mirtazapine both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (1)cyclobenzaprine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.cyclophosphamideMinor (1)cyclophosphamide will increase the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyproheptadineMonitor Closely (1)cyproheptadine and mirtazapine both increase sedation. Use Caution/Monitor.dabrafenibMonitor Closely (1)dabrafenib will decrease the level or effect of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.dacomitinibSerious - Use Alternative (1)dacomitinib will increase the level or effect of mirtazapine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. dantroleneMonitor Closely (1)dantrolene and mirtazapine both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)mirtazapine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darunavirMonitor Closely (1)darunavir increases levels of mirtazapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .dasatinibMonitor Closely (1)dasatinib and mirtazapine both increase QTc interval. Use Caution/Monitor.deferasiroxMonitor Closely (1)deferasirox increases levels of mirtazapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.degarelixMonitor Closely (1)degarelix and mirtazapine both increase QTc interval. Use Caution/Monitor.desfluraneMonitor Closely (1)desflurane and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)desflurane and mirtazapine both increase QTc interval. Avoid or Use Alternate Drug.desipramineMonitor Closely (2)desipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.