Remeron with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Remeron (Mirtazapine). Most antibiotics do not interfere meaningfully with Mirtazapine at 7.5mg, 15mg, 30mg, 45mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Anti-Depressants agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Mirtazapine at 7.5mg, 15mg, 30mg, 45mg.
Practical guidance
According to the prescribing information for Mirtazapine, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Remeron is co-administered. Adjusted 7.5mg, 15mg, 30mg, 45mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Remeron during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Mirtazapine is metabolised and may need a temporary 7.5mg, 15mg, 30mg, 45mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Remeron regimen.
Will antibiotics make Remeron stop working? ▾
Most antibiotics do not affect Remeron efficacy. Rifampicin and a few others can lower Mirtazapine levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
More on Remeron
- With alcoholRemeron and alcohol — is it safe to drink?
- With foodShould Remeron be taken with food?
- Side effectsRemeron side effects: common, rare and warning signs
- Dosage guideRemeron dosage guide: how much to take and when
- OnsetHow fast does Remeron start working?
- DurationHow long does Remeron last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.