Mirtazapine and Alprazolam Interaction
Drug interaction information between Mirtazapine and Alprazolam.
Mirtazapine and Alprazolam have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Mirtazapine and Alprazolam. 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
Taking these two drugs together can change the electrical timing of your heartbeat. This increases the risk of developing a dangerous irregular heart rhythm.
What To Do
Your doctor should monitor your heart rhythm closely if you take these together. Tell your provider right away if you feel dizzy or like your heart is racing.
FDA Label Information
Examples diazepam, alprazolam, alcohol Drugs that Prolong QTc Interval Clinical Impact The concomitant use of other drugs which prolong the QTc interval with mirtazapine, increase the risk of QTc prolongation and/or ventricular arrhythmias (e.g., Torsades de Pointes).
Mirtazapine Also Interacts With
- Linezolid major
- Diazepam moderate
- Phenelzine moderate
- Tranylcypromine moderate
- Selegiline moderate
Alprazolam Also Interacts With
- Ketoconazole moderate
- Clarithromycin moderate
- Itraconazole moderate
- Digoxin moderate
- Aprepitant moderate
Frequently Asked Questions
Can I take Mirtazapine and Alprazolam together?
This is a moderate interaction. Your doctor should monitor your heart rhythm closely if you take these together. Tell your provider right away if you feel dizzy or like your heart is racing.
How serious is the interaction between Mirtazapine and Alprazolam?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Mirtazapine and Alprazolam interact?
Taking these two drugs together can change the electrical timing of your heartbeat. This increases the risk of developing a dangerous irregular heart rhythm.
Understanding the Mirtazapine and Alprazolam Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Mirtazapine belongs to the Noradrenergic and Specific Serotonergic Antidepressant (NaSSA) class and Alprazolam belongs to the Benzodiazepine class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Taking these two drugs together can change the electrical timing of your heartbeat. 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. Mirtazapine has 29 total documented interactions on file in this dataset, and Alprazolam has 27. 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: Your doctor should monitor your heart rhythm closely if you take these together. 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 Mirtazapine or Alprazolam 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.