provider image
Welcome! You’re in GoodRx for healthcare professionals. Now, you’ll enjoy a streamlined experience created specifically for healthcare professionals.
Skip to main content
HomeDrugsMirtazapine

Mirtazapine and Alcohol: Is It a Risky Combination?

Rosanna Sutherby, PharmDAustin Ulrich, PharmD, BCACP
Published on July 16, 2025

Key takeaways:

  • Mixing mirtazapine (Remeron) and alcohol isn’t recommended. The combination may lead to side effects such as dizziness, sleepiness, and trouble concentrating. It can also increase the risk of more serious issues, such as worsening depression.

  • Combining mirtazapine and alcohol may be more risky for certain groups of people. This includes adults who are 65 years or older and those who have liver or kidney problems.

  • The safest bet is to avoid alcohol entirely while taking mirtazapine. However, since everyone reacts to alcohol differently, your prescriber can tell you whether you should avoid alcohol completely or if occasional drinks are OK.

Access savings on related medications

A man is looking at his phone while sitting at a bar.
mihailomilovanovic/E+ via Getty Images

Mirtazapine (Remeron) is a prescription-only antidepressant that’s FDA approved to treat depression in adults. It’s also sometimes prescribed off-label to treat other conditions, such as insomnia (trouble sleeping), post-traumatic stress disorder (PTSD), and generalized anxiety disorder.

Depression and anxiety are often intertwined with alcohol consumption. In fact, almost one-third of people who receive treatment for alcohol use disorder also have depression, and about half live with an anxiety-related health condition. 

Whether you drink alcohol regularly or just once in a while, it’s normal to wonder if it’s safe to mix it with mirtazapine. Keep reading to learn more about the potential downsides of mixing the two.

Promotion disclosure
Avg retail price
$9.00(Save Free%)
GoodRx discount
$9.00
How it works
drug-savings-illustration-1Use GoodRx to find medications, pharmacies, and discounts.
drug-savings-illustration-2GoodRx discounts can help you pay less for your prescription.
drug-savings-illustration-3Bring your free coupon or savings card to the pharmacy.

Can you take mirtazapine with alcohol?

It’s best to limit or avoid alcohol while taking mirtazapine. There are three main reasons for this, which are described below.

1. Increased side effects

Alcohol and mirtazapine can cause some of the same side effects. Taking them together may raise your risk of experiencing these effects — and make them feel stronger or more noticeable.

Common side effects shared by mirtazapine and alcohol include:

  • Dizziness

  • Coordination problems

  • Trouble concentrating

  • Confusion

  • Nausea

2. Potential liver harm

Mirtazapine may increase your liver enzyme levels. These enzymes, or proteins, help your liver do its job, which includes processing medications. A mild increase in these enzymes can happen during illness, but significantly high levels may signal liver damage.

Heavy alcohol use is a well-known cause of liver injury, so combining alcohol with mirtazapine could further strain your liver. While an occasional drink may not cause serious harm, limiting alcohol can help protect your liver while you’re taking mirtazapine.

3. Worsening depression symptoms

Drinking alcohol while taking an antidepressant, such as mirtazapine, may affect how your body responds to the antidepressant. This could mean that your depression symptoms worsen or come back.

GoodRx icon
  • Can you take mirtazapine (Remeron) for sleep? Pharmacists answer questions about this off-label mirtazapine use.

  • Mirtazapine interactions, explained: Mirtazapine and alcohol can interact negatively. Learn more about a few other mirtazapine interactions here.

  • How to take mirtazapine: It’s best to take mirtazapine as prescribed without skipping doses. This dosage guide explains typical mirtazapine dosages and what to do if you miss a dose.

What’s more, drinking alcohol could lead to skipping or forgetting to take mirtazapine doses. Skipping or missing doses could reduce the effects of the medication, which may result in worsening or returning depression symptoms.

What about just a drink or two? Is that safe with mirtazapine?

It’s hard to generalize if having just 1 or 2 drinks is safe with mirtazapine.

Some experts recommend avoiding alcohol altogether while taking mirtazapine. Mirtazapine alone can affect your coordination and concentration. Adding alcohol can intensify these side effects. This is especially risky for some people.

That said, not everyone will feel these effects to the same degree. Some people may be able to drink small amounts of alcohol without noticeable issues.

If you’re interested in having an occasional drink while prescribed mirtazapine, it’s best to talk with your healthcare team about how much alcohol is potentially safe to consume. They can make the final call on whether 1 or 2 drinks would be safe for you.

Keep in mind: While you may not always experience serious harm from drinking, no amount of alcohol is considered safe to drink. Even small amounts of alcohol can increase your risk of cancer, other health problems, and death. So it’s best for your health to avoid alcohol altogether.

Are certain people more at risk when combining alcohol and mirtazapine?

Yes, certain groups of people may be more at risk for side effects when combining alcohol and mirtazapine. This includes people who:

  • Are 65 or older

  • Have liver problems

  • Have kidney problems

Mirtazapine is cleared more slowly from the body in these groups of people. This means that there’s a greater chance the medication will build up and cause side effects.

How does alcohol interact with mirtazapine?

Alcohol mainly interacts with mirtazapine by increasing its side effects, especially those that affect your thinking and coordination.

What are the typical side effects of mirtazapine?

With or without alcohol consumption, common mirtazapine side effects include:

Are there any serious side effects or risks?

Although rare, it’s possible to have serious side effects with mirtazapine, including:

  • Skin reactions

  • Increased cholesterol levels

  • Low blood sodium levels

  • Low levels of platelets (cells that help with blood clotting)

  • Liver problems

  • Heart rhythm issues

  • Low white blood cell counts, which makes it harder to fight infections

  • Mania or hypomania in people with bipolar disorder

When should you get medical attention?

In rare cases, mixing mirtazapine and alcohol may result in more serious side effects. Call 911 or go to the nearest ER if you experience any of the following:

  • Thoughts of suicide or self-harm

  • Blood in your urine or stool

  • Bleeding that doesn’t stop

  • Extreme tiredness or drowsiness

  • Severe vomiting

Also seek emergency medical attention if you, a friend, or a loved one has any of the following symptoms of alcohol poisoning:

  • Confusion

  • Excessive sleepiness

  • Vomiting

  • Clammy, blue, or pale skin

  • Low body temperature

  • Slow heart rate

  • Abnormal or slowed breathing

  • Seizures

  • Loss of consciousness

For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text “HOME” to 741-741 to reach the Crisis Text Line.

When can you start drinking after taking mirtazapine?

Mirtazapine lasts about 4 to 10 days in the body. If your prescriber wants you to avoid alcohol altogether while taking mirtazapine, consider waiting at least 10 days after stopping mirtazapine to drink alcohol.

Keep in mind that mirtazapine is typically prescribed as a maintenance treatment for depression and other conditions. So it’s important to take it as prescribed and not skip doses or stop the medication without checking with your prescriber first.

You should also avoid stopping treatment with mirtazapine suddenly. Doing so could lead to withdrawal symptoms, such as:

  • Dizziness

  • Nausea or vomiting

  • Strange dreams

  • Sensations of pins and needles

  • Agitation or anxiety

  • Confusion

  • Fatigue

  • Headaches

The bottom line

Mirtazapine (Remeron) is a prescription-only antidepressant. It’s best to limit or avoid alcohol while taking mirtazapine. Mixing mirtazapine and alcohol can increase the likelihood of side effects such as excessive sleepiness, nausea, and problems with concentration and memory. It can also increase the risk of more serious side effects, including liver problems or worsening depression.

The safest thing to do is to avoid alcohol altogether with mirtazapine. But everyone processes and reacts to alcohol differently. Based on your medical history and lifestyle, your prescriber can tell you if you should avoid alcohol completely or if occasional drinks are OK.

why trust our exports reliability shield

Why trust our experts?

Rosanna Sutherby, PharmD
Rosanna Sutherby, PharmD, has been a community pharmacist in North Carolina for over 23 years. Before beginning her work as a medical writer, she held positions as a pharmacy manager, staff pharmacist, and immunizer.
Joshua Murdock, PharmD, BCBBS
Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.
Austin Ulrich, PharmD, BCACP
Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

References

Anker, J. J., et al. (2019). Co-occurring alcohol use disorder and anxiety. Alcohol Research.

DrugBank. (2025). Mirtazapine.

View All References (5)

Jilani, T. N., et al. (2024). Mirtazapine. StatPearls

McHugh, R. K., et al. (2019). Alcohol use disorder and depressive disorders. Alcohol Research.

National Institute on Alcohol Abuse and Alcoholism. (2025). Alcohol’s effects on the body. National Institutes of Health. 

RemedyRepack. (2025). Mirtazapine - mirtazapine tablet, film coated [package insert]

White, A., et al. (2025). Alcohol-medication interactions: Potentially dangerous mixes. National Institute on Alcohol Abuse and Alcoholism.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

Was this page helpful?

Habits for a Healthier Mind

Sign up for our GoodRx Mental Well-being Newsletter to receive up-to-date information on the latest medications, tips, and savings that are most relevant to you.

By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.

Browse medications

View All

Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.