Can I take Candesartan and Mirtazapine together?

Why this happens

Candesartan is a blood pressure medication (an ARB), and mirtazapine (an antidepressant) can sometimes cause a side effect called orthostatic hypotension (a drop in blood pressure upon standing). When used together, these effects can add up, leading to an increased risk of low blood pressure.

It is generally safe to take these together, but you should be cautious. Move slowly when changing positions (like getting out of bed). If you feel very dizzy or faint, sit or lie down immediately and contact your doctor. Your doctor may want to monitor your blood pressure more closely when you start mirtazapine.

Pregnancy

You must not take candesartan if you are pregnant. It can cause serious harm or death to an unborn baby, especially if used during the second and third trimesters. Use effective contraception while taking it.

Suicidal thoughts

Mirtazapine can cause an increase in suicidal thoughts or self-harm, particularly when first starting treatment or changing the dose. Seek immediate medical help if your mood worsens or you have distressing thoughts.

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.

Alcohol

You should be very careful about drinking alcohol while taking these medicines. Candesartan can lower your blood pressure, and alcohol can increase this effect, making you feel dizzy or light-headed. Mirtazapine can make you feel sleepy, and alcohol will significantly increase this drowsiness and affect your alertness. It is best to keep alcohol intake to a minimum or avoid it entirely until you know how these medicines affect you.

Potassium-rich foods (e.g., bananas, spinach, salt substitutes)

Candesartan can increase the levels of potassium in your blood. Consuming large amounts of foods very high in potassium or using potassium-based salt substitutes (such as Lo-Salt) can lead to dangerously high potassium levels (hyperkalaemia). You should avoid using potassium-based salt substitutes unless advised otherwise by your doctor.

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.