Can I take Mirtazapine and Paracetamol together?

You can take paracetamol while you are taking mirtazapine as they 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.

How to take mirtazapine and paracetamol safely

• 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.

Important precautions

Suicidal thoughts and worsening of depression

Mirtazapine 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.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Combining alcohol with paracetamol increases the risk of serious liver damage. Combining alcohol with mirtazapine can significantly increase drowsiness and impair your coordination and judgement.

Caffeine (Coffee, Tea, Energy Drinks)

Caffeine can counteract the sedative effects of mirtazapine, potentially making the medicine less effective for sleep or increasing feelings of anxiety.

Using other medicines

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.