Do not take mirtazapine with
- any of the other medicines listed in the table Medicines that may increase risk of serotonin toxicity, unless under careful medical supervision
- illegal drugs
- moclobemide and wait at least 2 days after stopping moclobemide before taking mirtazapine, because it may cause serotonin toxicity or a serious reaction with severe high blood pressure.
Tell your doctor if you are taking any of the following
Always tell your doctor about all other medicines you are taking, including over-the-counter and complementary or alternative medicines. You may need careful monitoring or a change in dose to avoid side effects if you are taking other medicines, including:
- carbamazepine (Tegretol, Teril) or phenytoin (Dilantin), medicines used to treat epilepsy
- benzodiazepines, medicines used to treat anxiety and sleeping problems
- medicines that increase the risk of gastrointestinal bleeding such as warfarin (Coumadin, Marevan), ticlopidine (Tilodene), aspirin (e.g. Aspro) and nonsteroidal anti-inflammatory drugs, used to treat pain and inflammation
- erythromycin (e.g. EES, E-Mycin, Eryc), an antibiotic
- rifampicin (e.g. Rifadin, Rimycin), an antibiotic
- medicines used to treat fungal infections such as ketoconazole (Nizoral tablets) and itraconazole (Sporanox)
- HIV/AIDS medicines
- cimetidine (Magicul, Tagamet), a medicine used to treat gastric reflux and stomach ulcers.
Mirtazapine and alcohol
Mirtazapine may increase the effects of alcohol. Talk to your doctor about safe limits for you.
Who can I ask about interactions?
Call the NPS Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a pharmacist. Your call will be answered by healthdirect Australia.
Find out more about
- What mirtazapine does and how effective it is
- Who mirtazapine is for and who should be cautious
- Side effects of mirtazapine
- Brands of mirtazapine
If you are starting mirtazapine, see 10 things you should know about antidepressants.
For more information
- Starting, switching and stopping antidepressants
- Managing side effects of antidepressants
- Psychological therapies
The consumer medicine information (CMI) for your brand of mirtazapine is available from our website or a pharmacist. If you have any concerns about interactions, talk to your health professional. The CMI includes:
- how to take this medicine
- what to do if you forget to take it
- if you take too much (overdose)
- things you must and must not do while taking this medicine
- signs of severe reactions and what to do.
- Rossi S, ed. eAMH [online]. Adelaide: Australian Medicines Handbook, 2012. www.amh.net.au. (Accessed 9 February 2012).
- Psychotropic Expert Group. Therapeutic Guidelines: Psychotropic, Version 6. In: eTG complete [CD-ROM]. Melbourne: Therapeutic Guidelines Limited; 2008.
- Merck Sharp and Dohme (Australia) Pty Ltd. Avanza consumer medicine information. September 2011. (Accessed 22 March 2012).