Mirtazapine Clozapine

Carbamazepine and possibly the antidepressant mirtazapine should not be coadministered with clozapine because these drugs may further increase the risk of agranulocytosis. In addition, the antidepressant bupropion should not be coprescribed with clozapine because it may increase clozapine s seizure risk. 

Albuterol Salbutamol Clenbuterol Fenoterol Adrafanil Fluparoxan Modafinil Idazoxan Mirtazapine [also 5-HT2] Yohimbine Clozapine Bupropion... 

D6 Tricyclic antidepressants (TCAs), benztropine, perphenazine, clozapine, haloperidol, codeine/oxycodone, risperidone, class Ic antiarrhythmics, 3 blockers, trazodone, paroxetine, maprotiline, amoxapine, duloxetine, mirtazapine (partly), venlafaxine, bupropion Fluoxetine, paroxetine, duloxetine, hydroxybupropion, methadone, cimetidine, haloperidol, quinidine, ritonavir Phenobarbital, rifampin... 

Antidepressants mirtazapine, nefazodone, sertraline Neuroleptics thioridazine, haloperidol, clozapine, quetiapine, risperidone, sertindole, ziprasidone Mood stabilizers carbamazepine, gabapentin, lamotrigine... 

V. Drug or laboratory interactions. There is some evidence that milk thistle may inhibit CYP2C9 and CYP3A4 enzyme activity, which might theoretically increase plasma levels of dmgs metabolized by these enzymes, including amitriptyline, diazepam, clozapine, warfarin, mirtazapine, ketoconazole, and others. Drug interactions with milk thistle extract have not been reported in humans. 

There are isolated cases of apparent interactions between clozapine, and ampicillin, buspirone, caffeine, haloperidol, loperamide, modafinil, nefazodone, nicotinic acid, tryptophan, or vitamin C. Grapefruit juice, influenza vaccine mirtazapine, reboxetine, or venlafaxine do not appear to interact Cocaine levels may increase when taken with clozapine. 

A study in 9 patients taking clozapine in doses ranging from 100 to 650 mg daily found no significant change in the pharmacolanetics of clozapine after the addition of mirtazapine 30 mg daily. ... 

Zoccali R, Muscatello MR, La Tcwe D, Ivkilara G, Canale A, Crucitti D, D Arrigo C, Spina E. Lack of a pharmacokinetic interaction between mirtazapine and the newer antipsychotics clozapine, risperidone and olanzapine in patients with chronic schizoii enia. Pharm Res (2003) 48,411-14. 

Limited evidence suggests that risperidone does not appear to affect mirtazapine pharmacokinetics. Mirtazapine does not appear to interact to a ciinicaiiy reievant extent with clozapine, olanzapine or risperidone. 

Another study in 24 schizophrenic patients investigated the effect of adding mirtazapine 30 mg at bedtime, for 6 weeks, to treatment with clozapine (9 patients), risperidone (8), or olanzapine (7). Mirtazapine had a negligible effect on the metabolism of all three drugs and the combination was well tolerated. ... 

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