ModerateSelective beta-adrenergic blockers×Other antidepressants (NaSSA)
Updated · Methodology
Mechanism
Additive hypotension and sedation. Mirtazapine blocks α2-adrenergic and 5-HT2 receptors, causing orthostatic effects.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
The combination is acceptable at low mirtazapine doses (15–30 mg). Warn the patient about drowsiness and orthostatic dizziness, especially in the first 1–2 weeks. Check blood pressure standing and sitting.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Bisoprolol tablet (Micro Labs Limited) – Prescribing Information (2016)– ; DailyMed setid c3ee566c-74c4-45f4-a947-526a7313e326