Hydromorphone and Mirtazapine Interaction
Drug interaction information between Hydromorphone and Mirtazapine.
Hydromorphone and Mirtazapine have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Hydromorphone and Mirtazapine. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
These medications both change how serotonin works in your brain, which increases the risk of a severe and potentially dangerous reaction.
What To Do
Use this combination with caution and report any unusual changes in your mood or physical coordination to your doctor.
FDA Label Information
Examples: Selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase (MAO) inhibitors (those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue).
Hydromorphone Also Interacts With
- Trazodone minor
- Tramadol minor
- Cyclobenzaprine minor
- Linezolid minor
- Phenelzine minor
Mirtazapine Also Interacts With
- Linezolid major
- Alprazolam moderate
- Diazepam moderate
- Phenelzine moderate
- Tranylcypromine moderate
Frequently Asked Questions
Can I take Hydromorphone and Mirtazapine together?
This is a minor interaction. Use this combination with caution and report any unusual changes in your mood or physical coordination to your doctor.
How serious is the interaction between Hydromorphone and Mirtazapine?
This interaction is classified as "minor" severity by the FDA. Minor interactions are unlikely to cause significant problems but should still be mentioned to your healthcare provider.
Why do Hydromorphone and Mirtazapine interact?
These medications both change how serotonin works in your brain, which increases the risk of a severe and potentially dangerous reaction.
Understanding the Hydromorphone and Mirtazapine Interaction
FDA-approved prescribing information for these two drugs flags their combination as a minor-severity interaction. Hydromorphone belongs to the Opioid Analgesic class and Mirtazapine belongs to the Noradrenergic and Specific Serotonergic Antidepressant (NaSSA) class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: These medications both change how serotonin works in your brain, which increases the risk of a severe and potentially dangerous reaction. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Hydromorphone has 13 total documented interactions on file in this dataset, and Mirtazapine has 29. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Use this combination with caution and report any unusual changes in your mood or physical coordination to your doctor. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Hydromorphone or Mirtazapine based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.