Can I take Mirtazapine and Clopidogrel together?

Why this happens

Mirtazapine can affect how platelets (the cells that help your blood clot) work. Clopidogrel is a 'blood thinner' specifically designed to stop platelets from sticking together. When used together, their effects on platelets can add up, making it harder for your blood to clot if you are injured or have an internal bleed.

You can take these medicines together, but you should be aware of the increased bleeding risk. Watch out for signs of unusual bleeding, such as dark or tarry stools, coughing up blood, blood in your urine, or large bruises that appear for no reason. If you notice any of these, or if you have a cut that will not stop bleeding, contact your doctor immediately. Do not stop taking either medication without speaking to your doctor first.

Depression and mental health disorders

Mirtazapine can increase thoughts of self-harm or suicide, particularly when you first start taking it or when your dose is changed. You must tell someone you trust that you are taking this medicine and seek medical help immediately if your mood worsens or you have distressing thoughts.

Bleeding risk and surgery or dental work

Clopidogrel thins your blood. You are at a higher risk of serious bleeding, such as in your stomach or brain. Seek urgent medical help if you have black stools, vomit blood, or experience bruising that you cannot explain.

You must tell your surgeon or dentist that you are taking clopidogrel before any procedure, as you may need to stop taking it temporarily to prevent excessive bleeding.

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.

Serotonin Syndrome

When taken with other medicines that affect serotonin, mirtazapine can cause a life-threatening reaction called serotonin syndrome. Seek emergency help if you experience a combination of agitation, hallucinations, fast heartbeat, shivering, or severe muscle stiffness.

Alcohol

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.

It is best to avoid or strictly limit alcohol while taking clopidogrel. Both alcohol and clopidogrel can irritate the stomach lining and increase the risk of internal bleeding, particularly in the stomach and intestines.

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.

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.