Can I take Mirtazapine and Pregabalin together?

Why this happens

Both medicines work by slowing down activity in the central nervous system (the brain and nerves). When taken together, their sedative effects add up, leading to a stronger effect than either drug would have on its own.

What you should do

Use this combination with caution. Avoid driving or operating heavy machinery until you know how these medicines affect you. Do not drink alcohol while taking these, as it will make the sleepiness much worse. If you feel extremely drowsy or have trouble breathing, contact your doctor immediately.

Important precautions

Suicidal thoughts and self-harm

Antidepressants and medicines for nerve pain can increase the risk of suicidal thoughts or self-harm, particularly when first starting treatment or changing doses. Monitor your mood closely and seek urgent medical help if you experience any distressing thoughts.

Drug dependence and addiction

Pregabalin is a controlled drug because it carries a risk of dependence and addiction. You must only take the dose prescribed and should not stop taking it suddenly, as this can cause severe withdrawal symptoms.

Serotonin Syndrome

When taken with other serotonergic medicines, mirtazapine can cause a life-threatening condition called serotonin syndrome. Seek immediate medical attention if you experience high fever, agitation, shivering, or severe muscle twitching.

Agranulocytosis (low white blood cells)

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 while taking these medicines. Both mirtazapine and pregabalin cause drowsiness and dizziness; alcohol significantly increases these effects, which can lead to dangerous levels of sedation, impaired coordination, and an increased risk of falls or accidents. Combining them also increases the risk of respiratory depression (slowed breathing).

Caffeine (Coffee, Tea, Energy Drinks)

Mirtazapine is often prescribed to help with sleep and anxiety. Caffeine is a stimulant that can counteract the sedative effects of mirtazapine, potentially making your treatment less effective or increasing feelings of restlessness and 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.