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Detailed medicine guidance

Taking mirtazapine with other medicines and herbal supplements

NHS medicines information on possible interactions with mirtazapine and other medicines, herbal remedies and supplements.

About this information

This NHS content is written for people in England. Medicine names, availability, prescribing and services may differ in other countries.

Cautions with other medicines

Some medicines and mirtazapine can affect each other and increase the chances of you having side effects.

Tell your doctor or pharmacist if you're taking:

  • any other medicines for depression, or if you've taken them recently – some antidepressants can affect mirtazapine to cause very high blood pressure even after you've stopped taking them
  • medicines that make you feel sleepy, including strong painkillers like morphine or muscle relaxants like diazepam
  • warfarin – mirtazapine can affect warfarin so your doctor may need to change your warfarin dose
  • epilepsy medicines such as carbamazepine or phenytoin – these medicines can reduce the effects of mirtazapine, so your doctor may prescribe a higher dose
  • rifampicin – this antibiotic can reduce the effects of mirtazapine, so your doctor may prescribe a higher dose
Mixing mirtazapine with herbal remedies and supplements

Do not take the herbal remedy St John's wort while you're being treated with mirtazapine, as this will increase your risk of side effects.

There's not enough information to say that other herbal remedies or supplements are safe to take with mirtazapine. They're not tested in the same way as pharmacy and prescription medicines.

Meds New IA (H2) - Cautions with other medicines alert

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

View the original NHS website page ↗. Refreshed 19 August 2026.

Licensed under the Open Government Licence v3.0 ↗. MyPHU is independent and is not endorsed by the NHS.

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