Clonidine/Tricyclic Compounds; Mirtazapine
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
The cause of this interaction is not known.
What might happen:
The beneficial effects of your blood pressure medicine may be decreased.
What you should do about this interaction:
You should check your blood pressure regularly. Tell your doctor if there is a change in your blood pressure, since he may need to change the dose of your medicine depending on your blood pressure. You should also tell your doctor if you have any chest pain or shortness of breath, or if you have any dizziness, headache, or blurred vision.Make sure that your doctor knows all of the medicines that you are taking.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Blaschke TP, Melmon KL. Antihypertensive agents and the drug therapy of hypertension. In Gilman, A.G., Goodman, L.S., and Gilman,A., editors: The Pharmacological Basis of Therapeutics, New York, 1980, Macmillan Publishing..
2.Checkley SA, Slade AP, Shur E, Dawling S. A pilot study of the mechanism of action of desipramine. Br J Psychiatry 1981 Mar;138:248-51.
3.Troncoso AL, Gill T. Hypertensive urgency with clonidine and mirtazepine. Psychosomatics 2004 Sep-Oct;45(5):449-50.
4.van Spanning HW, van Zwieten PA. The interference of tricyclic antidepressants with the central hypotensive effect of clonidine. Eur J Pharmacol 1973 Dec;24(3):402-4.
5.van Zwieten PA. Interaction between centrally acting hypotensive drugs and tricyclic antidepressants. Arch Int Pharmacodyn Ther 1975 Mar; 214(1):12-30.
6.Stiff JL, Harris DB. Clonidine withdrawal complicated by amitriptyline therapy. Anesthesiology 1983 Jul;59(1):73-4.
7.Lacomblez L, Warot D, Bouche P, Derouesne C. Suppression of the antihypertensive effect of clonidine by clomipramine. Rev Med Interne 1988 May-Jun;9(3):291-3.
8.Andrejak M, Fournier A, Hardin JM, Coevoet B, Lambrey G, De Fremont JF, Quichaud J. Suppression of the antihypertensive effect of clonidine by the simultaneous intake of a tricyclic antidepressive agent. Practical problem in the treatment of a depressed hypertensive patient. Nouv Presse Med 1977 Sep 10;6(29):2603.
9.Briant RH, Reid JL, Dollery CT. Interaction between clonidine and desipramine in man. Br Med J 1973 Mar 3;1(5852):522-3.
10.Briant RH, Reid JL. Desmethylimipramine and the hypotensive action of clonidine in the rabbit. Br J Pharmacol 1972 Nov;46(3):563P-564P.
11.Zwieten PA. The reversal of clonidine-induced hypotension by protriptyline and desipramine. Pharmacology 1976;14(3):227-31.
12.Hui KK. Hypertensive crisis induced by interaction of clonidine with imipramine. J Am Geriatr Soc 1983 Mar;31(3):164-5.
13.Conolly ME. In: Conolly ME., editor: Catapres in Hypertension, London, 1969, Butterwoth's Publishing..
14.Coffier DE, et al. Antipsychotic drug interaction. Drug Intell Clin Pharm 1976;10:114.
15.Siever LJ, Cohen RM, Murphy DL. Antidepressants and alpha 2-adrenergic autoreceptor desensitization. Am J Psychiatry 1981 May;138(5):681-2.
16.Cubeddu LX, Cloutier G, Gross K, Grippo R, Tanner L, Lerea L, Shakarjian M, Knowlton G, Stat M, Harden TK, et al. Bupropion does not antagonize cardiovascular actions of clonidine in normal subjects and spontaneously hypertensive rats. Clin Pharmacol Ther 1984 May;35(5):576-84.
17.Abo-Zena RA, Bobek MB, Dweik RA. Hypertensive urgency induced by an interaction of mirtazapine and clonidine. Pharmacotherapy 2000 Apr; 20(4):476-8.
18.Flexeril (cyclobenzaprine hydrochloride) US prescribing information. Merck & Co., Inc. 1985.
19.Elliott HL, Whiting B, Reid JL. Assessment of the interaction between mianserin and centrally-acting antihypertensive drugs. Br J Clin Pharmacol 1983;15 Suppl 2:323S-328S.
20.Elliott HL, McLean K, Sumner DJ, Reid JL. Absence of an effect of mianserin on the actions of clonidine or methyldopa in hypertensive patients. Eur J Clin Pharmacol 1983;24(1):15-9.
21.Gundert-Remy U, Amann E, Hildebrandt R, Weber E. Lack of interaction between the tetracyclic antidepressant maprotiline and the centrally acting antihypertensive drug clonidine. Eur J Clin Pharmacol 1983; 25(5):595-9.