Can I take Mirtazapine and Paracetamol together?

Why this happens

Mirtazapine and paracetamol are processed by different pathways in the liver and do not interfere with how the other is absorbed, broken down, or removed from the body. They also work on different systems in the body (mirtazapine on brain chemicals for mood, and paracetamol on pain and temperature regulation), so they do not have overlapping side effects.

You can take paracetamol while you are taking mirtazapine. Always follow the dosage instructions on the packet for paracetamol and do not exceed the maximum daily dose (usually 4000mg or eight 500mg tablets in 24 hours). If you feel unusually drowsy, speak to your pharmacist or doctor, as mirtazapine can sometimes cause tiredness on its own.

Suicidal thoughts and worsening of depression

This medicine can occasionally cause an increase in suicidal thoughts or self-harm, particularly when first starting treatment or changing doses. Patients and carers must monitor for any sudden changes in mood or behaviour.

Agranulocytosis (low white blood cell count)

Mirtazapine can rarely cause a serious drop in white blood cells. You must contact a doctor immediately if you develop a fever, sore throat, mouth ulcers, or any other signs of infection.

Liver damage from overdose

Paracetamol is highly toxic to the liver in overdose. You must never exceed the maximum dose of 8 tablets (4g) in 24 hours and must check that other medicines (such as cold and flu remedies) do not also contain paracetamol.

Alcohol

Drinking alcohol while taking mirtazapine can make you feel very sleepy and unsteady on your feet. It is best to avoid alcohol, especially when you first start treatment or if your dose is increased.

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.