Combination of Meds

Hello Nurses,

My GP is prescribing me Mirtazapine for sleep and depression. I’m afraid I did Dr Google and am now a bit worried about the effect of this drug on my white cell count. I am already on 600mg of Ribociclib and have regular blood tests and had low cell count once so had a 2 week break instead of one and then back on it.

Would another option be better for me - I will of course talk to my Oncologist at next appt but am supposed to start this medication asap so thought I would check with you first.

Thanks very much.

Hi @michellem55 ,

Thanks for posting on our forum.

We hope to be able to respond to you soon.

In the meantime our helpline is open from 9am tomorrow.

If you do phone our helpline, please let us know that you have asked a question on our forum so that we know your query has been answered, thank you.

Best wishes,

Charlotte

Ask Our Nurses service coordinator

Please read the disclaimer

Full details on how we collect and use your data can be found in our Privacy Policy

Hello @michellem55,

Thanks for posting.

It’s understandable that you’re concerned about the possible effects of mirtazapine on your white blood cell count as you are already taking ribociclib.

A reduction in the white cell count is not a common side effect of mirtazapine. There is some evidence that bone marrow suppression may occur when taking mirtazapine and this could cause a reduction in the white cell count. However, this is not a common side effect and there is not enough data available to say how often this might happen. As your blood counts will be being monitored during your treatment with ribociclib any change should be picked up quickly by your treatment team.

In some people ribociclib may cause an increase in the blood levels of mirtazapine leading to a possibility of increased side effects. Before starting any new medication or supplement it’s important for you to discuss it with your treatment team.

You’ve said that you have an appointment with your oncologist but, in the meantime, you may wish to discuss this with your hospital oncology pharmacist (by going through the hospital switchboard) who will be able to give more information. You could also contact your breast care nurse for advice. You do not have to wait until your oncology appointment.

Many people experience low mood after a diagnosis of breast cancer and our information on low mood and depression may be of interest.

CAN-EMPOWER is a website developed to help with the emotional challenges of a cancer diagnosis which you may also find helpful.

We also have information on managing difficulty with sleeping.

We offer a range of free supportive services which you may be interested in. They include face to face and online courses and events.

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.

Our number is 0808 800 6000. If you have hearing or speech difficulties dial 18001 followed by our number and the call will go through Relay UK. Our helpline has access to telephone interpreters if language translation is required.

If you would prefer one of our nurses to call you. Please complete this form ticking the box agreeing to a call back.

Our usual opening hours are Monday to Friday 9am - 4pm and 9am -1pm on Saturdays.

We are closed on English bank holidays.

Out of hours you can leave a message and we will call you back when we next open.

Best wishes,

Julie

Breast Care Nurse

Please read the disclaimer Full details on how we collect and use your data can be found in our Privacy Policy

As we are unable to monitor for further replies, this thread will now be closed. If you have any additional questions or would like to provide feedback, please start a new thread, call our helpline, email us or request a call back.