Can I take Atorvastatin and Mirtazapine together?

Why this happens

Atorvastatin and mirtazapine are processed by different pathways in the liver. Atorvastatin is primarily broken down by an enzyme called CYP3A4, while mirtazapine is processed by several different enzymes (CYP2D6, CYP1A2, and CYP3A4). Because mirtazapine does not strongly block or speed up the enzymes that atorvastatin relies on, it does not significantly change the levels of atorvastatin in your blood.

What you should do

You can take these medicines together as prescribed by your doctor. As with any statin (like atorvastatin ), you should always report any unexplained muscle pain, tenderness, or weakness to your doctor, but this risk is not increased by taking mirtazapine.

Important precautions

Depression and mental health disorders

Mirtazapine can cause an increase in suicidal thoughts or self-harm, particularly when first starting treatment or changing the dose. Monitor your mood closely and seek immediate medical help if you notice any distressing changes.

Pregnancy

Do not take atorvastatin if you are pregnant or planning to become pregnant, as it may harm your unborn baby. Use effective contraception while taking this medicine.

Muscle problems (Myopathy) - atorvastatin

Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness. In rare cases, this can lead to serious kidney problems.

Serotonin Syndrome

When mirtazapine is taken with other medicines that affect serotonin, there is a risk of serotonin syndrome. Seek immediate help if you experience agitation, hallucinations, fast heartbeat, or severe muscle stiffness.

Low white blood cell count (Agranulocytosis)

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

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol when taking atorvastatin. Both alcohol and atorvastatin can affect your liver; combining them increases the risk of liver damage and may increase the risk of muscle side effects.

It is best to avoid or strictly limit alcohol while taking mirtazapine. Both alcohol and mirtazapine cause drowsiness and can affect your coordination; combining them significantly increases these effects, making you feel very sleepy and increasing the risk of accidents.

Grapefruit juice

Avoid drinking large quantities of grapefruit juice (more than 1.2 litres a day). Grapefruit contains compounds that can increase the level of atorvastatin in your blood, which raises your risk of serious side effects like muscle damage.

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.