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Can I take Metformin and Mirtazapine together?

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Taking mirtazapine alongside metformin may occasionally affect your blood sugar levels. While mirtazapine is generally considered 'weight-neutral' compared to other antidepressants, it can sometimes cause an increase in appetite or weight gain, which might make it slightly harder for metformin to control your blood sugar.

There is also a very small risk that mirtazapine could interfere with how your body processes sugar, potentially leading to higher blood glucose levels.

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Perché succede

La mirtazapina può a volte causare cambiamenti metabolici, come un aumento dell'appetito o cambiamenti nel modo in cui il corpo risponde all'insulina. Questo può contrastare gli effetti di riduzione della glicemia della metformina.

Di solito puoi prendere metformina e mirtazapina together, but you should monitor your blood sugar levels more closely when you first start mirtazapine or if your dose changes.

If you notice your blood sugar readings are consistently higher than usual, or if you feel unusually thirsty or tired, speak to your GP. They may need to adjust your metformin dose or give you advice on managing your weight.

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Depressione e disturbi mentali

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.

Acidosi lattica

Metformin can cause a rare but serious build-up of acid in the blood. Seek urgent medical help if you experience extreme tiredness, muscle pain, or difficulty breathing. This risk is higher if you have severe kidney problems or drink excessive alcohol.

Severe dehydration or infection

If you develop severe vomiting, diarrhoea, or a high fever, you must temporarily stop taking metformin and contact your doctor to prevent kidney strain.

Medical scans using iodine contrast dye

If you are having an X-ray or scan involving an injection of iodine contrast dye, you must stop taking metformin before or at the time of the test to prevent sudden kidney failure.

Sindrome serotoninergica

Taking mirtazapine alongside other serotonergic substances (such as serotonin supplements) significantly increases the risk of serotonin syndrome, a potentially life-threatening condition. Symptoms include agitation, hallucinations, rapid heartbeat, and 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.

Alcol

It is best to avoid or strictly limit alcohol while taking metformin. Drinking alcohol with this medicine increases the risk of a rare but serious condition called lactic acidosis (a build-up of lactic acid in the blood). It also increases the risk of low blood sugar (hypoglycaemia).

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.

Vitamin B12 absorption

Long-term use of metformin can prevent your body from absorbing enough vitamin B12 from your food. You may need to have your B12 levels checked by your doctor or take a supplement if you develop symptoms like extreme tiredness or a sore tongue.

General Food Advice

Metformin should be taken with or just after a meal or snack. This helps to reduce the risk of common side effects such as stomach upset, indigestion, or nausea.

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Avvertenza

Queste informazioni sono solo a scopo educativo generale e non devono essere considerate un sostituto del consiglio medico professionale. Consultate sempre il vostro medico di base, farmacista o un altro professionista sanitario qualificato prima di prendere decisioni sui vostri farmaci. Le circostanze individuali possono variare, e solo un professionista sanitario che conosce la vostra storia medica può fornire una guida personalizzata.

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Storia dell'articolo

Le informazioni su questa pagina sono scritte e revisionate da clinici qualificati.

  • 25 Gen 2026 | Pubblicato originariamente
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