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Hi, I Have Some Mirtazapine Which I Haven’t Started Yet.

Posted on Fri, 11 Aug 2023

Question: Hi, I have some mirtazapine which I haven’t started yet. I have had it one night and made me really tired all day the next day. I know that’s a side effect. I’m taking phenergan, without codeine at the moment for nausea. Is it ok to have these 2 together?
Also can you just have mirtazapine occasionally?

Answered by Dr. Pallavi.m (1 hour later)

Brief Answer:
Mirtazapine and phenergan should not be used together.

Detailed Answer:
Hello sir, thank you for choosing healthcare magic. Mirtazapine and phenergan both can't be taken together as they both increase sedation. If you want to have mirtazapine before bed, please avoid phenergan that day. You cant have mirtazapine occasionally because if you stop that drug abruptly, it can cause the following symptoms :
1)dizziness
2)abnormal dreams,
3)sensory disturbances (including paresthesia and electric shock sensations),
4) agitation,
5)anxiety,
6)fatigue,
7)confusion, headache, tremor, nausea, vomiting, and sweating
So if you want to take mirtazapine, take it daily before bed and don't stop it abruptly. Gradual decrease in dose over few weeks is recommended.
Hope i have answered your question. Please let me know if you need any further assistance. Thank you. Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Pallavi.m (5 minutes later)

Ok thanks. Is the only risk of having both extra sedation?
Having it once a week or so isn’t ok?

Follow up: Dr. Pallavi.m (10 minutes later)

Also is phenergan ok to take for a while? It doesn’t have codeine in it.
It won’t give withdrawals if I stop

Answered by Dr. Pallavi.m (17 minutes later)

Brief Answer:
Mirtazapine and phenergan together cause cardiac rhythm disturbances

Detailed Answer:
Hello sir. There can be heart rhythm disturbances when mirtazapine and phenergan are taken together. So please avoid the combination. Yes you can take mirtazapine once a week before bed.
Phenergan can be used for a while. But stopping phenergan abruptly can cause withdrawal symptoms like :
Sweating
Low BP
Vomiting
Insomnia
So, the dose can be gradually decreased by 25-50% in 1-4 weeks.
Hope I have answered your question. Please let me know if you need any further assistance. Thank you. Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Pallavi.m (1 hour later)

Thanks, the chemist told me only problem when stopping phenergan would be trouble sleeping if that’s what I was using it for because it doesn’t have codeine in it.

Answered by Dr. Pallavi.m (55 minutes later)

Brief Answer:
Yes you may face difficulty in sleeping if you abruptly stop phenergan.

Detailed Answer:
Hello sir, yes you will face difficulty in sleeping along with other symptoms as i mentioned in my previous reply, if you abruptly stop phenergan. Even if that doesn't have codeine, phenergan itself causes some sedation.
Hope i have answered your question. Please let me know if you need any further assistance. Thank you. Take care.

Above answer was peer-reviewed by : Dr. LAKSHMI

Follow up: Dr. Pallavi.m (3 hours later)

Ok. I’m confused now because another doctor on here said no withdrawals. Not sure what’s the right information. I added a pic of his answer

Answered by Dr. Pallavi.m (1 hour later)

Brief Answer:
Phenergan has no addictive potential.

Detailed Answer:
Hello sir, please don't get confused. I never said phenergan is addictive. I only said if you take it for several weeks or a considerable amount of time, you may face difficulty in sleeping when you stop it. Withdrawal effects are seen when combined with codeine.
Hope I'm clear now. There is no addiction with phenergan but there may be sleeping difficulty with long term use.
Thank you. Take care.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Pallavi.m (57 minutes later)

Ok thanks

Answered by Dr. Pallavi.m (20 minutes later)

Brief Answer:
Most welcome.

Detailed Answer:
You are most welcome sir. Hope i have answered your question. Please let me know if you need any further assistance. Thank you. Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Pallavi.m (13 hours later)

Sorry one last one. Is propranolol ok to take occasionally? Will it interact with the mirtazapine?

Answered by Dr. Pallavi.m (30 minutes later)

Brief Answer:
No interactions between propranolol and mirtazapine.

Detailed Answer:
Hello sir, thank you for choosing healthcare magic. You can use propranolol. There are no interactions between propranolol and mirtazapine.
Hope i have answered your question. Please let me know if you need any further assistance. Thank you. Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Pallavi.m (26 hours later)

Thanks, how many days in a row of taking mirtazapine can you take before you would have to wean off it?

Answered by Dr. Pallavi.m (1 hour later)

Brief Answer:
Please take it for 3-4 weeks to experience it's effects

Detailed Answer:
Hello sir, thank you for choosing healthcare magic. Mirtazapine takes atleast 2 -3 weeks to show it's effects. Full blown function is seen at 4-6 weeks. So I would advise you to take Mirtazapine atleast for 3-4 weeks to experience it's effects.
Then gradually wean off over several weeks.
Hope i have answered your question. Please let me know if you need any further assistance. Thank you. Take care.

Above answer was peer-reviewed by : Dr. LAKSHMI

Follow up: Dr. Pallavi.m (48 hours later)

I also take 40mg citalopram in the morning. I checked a drug interaction and said phenergan has potentially more interaction than the mirtazapine with the citalopram. I haven’t had any issues yet with the 2 and my doctor said it was ok. So still wondering is there a major risk of taking phenergan and mirtazazpine? Not at the same time though

Answered by Dr. Pallavi.m (2 hours later)

Brief Answer:
Please take these drugs on different days rather than on the same day.

Detailed Answer:
Hello sir, thank you for choosing healthcaremagic. Yes, citalopram has serious interactions with Phenergan. My advise is to take citalopram and Phenergan on different days rather than on same day. Mirtazapine and Phenergan also to be taken on different days to be safe.
Hope I have answered your question. Please let me know if you need further assistance. Thank you. Take care.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Nagamani Ng