mirtazapine, Remeron, Soltab (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Fluvoxamine (Luvox), ketoconazole (Nizoral) and cimetidine (Tagamet) may increase the levels of mirtazapine in the blood which may lead to increased side effects from mirtazapine. Carbamazepine (Tegretol) and phenytoin (Dilantin) decrease the blood concentration of mirtazapine by increasing the breakdown of mirtazapine in the liver, possibly reducing the effect of mirtazapine.

Mirtazapine should not be used with monoamine oxidase (MAO) inhibiting drugs such as phenelzine (Nardil), procarbazine (Matulane), selegiline (Eldepryl), or tranylcypromine (Parnate). High fever, convulsions, and even death can occur from such combinations. Therefore, an interval of 14 days is recommended between stopping MAO inhibitor therapy and starting mirtazapine, and vice versa. Similar reactions may occur if mirtazapine is combined with other drugs that increase serotonin activity in the brain. Such drugs to avoid include tryptophan, sumatriptan (Imitrex), linezolid (Zyvox), fluoxetine (Prozac), venlafaxine (Effexor), lithium (Eskalith, Lithobid), tramadol (Ultram), and St. John's wort.

PREGNANCY: There are no adequate studies of mirtazapine in pregnant women. Thus, physicians must balance potential benefits against potential risks when considering mirtazapine therapy in pregnant women.

NURSING MOTHERS: It is not known if mirtazapine is secreted in breast milk.

Medically reviewed by Eni Williams, PharmD

REFERENCES:

FDA Prescribing Information for mirtazapine

AHFS Drug Information for mirtazapine


Medically Reviewed by a Doctor on 12/11/2014


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