Drug & supplement interaction

German Chamomile + Mirtazapine

Mirtazapine brand name: Remeron.

Moderate Interaction
The bottom line Moderate

Mirtazapine falls into 3 drug categories that German Chamomile can interact with; the most serious is rated moderate. Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

German Chamomile and Mirtazapine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

German Chamomile interacts with whole categories of medication. Mirtazapine falls into 3 of those categories, so it can interact with German Chamomile in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 3

Why this applies to Mirtazapine

Mirtazapine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group German Chamomile interacts with.

Theoretically, German chamomile might inhibit CYP2D6 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP2D6. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP2D6 in patients taking German chamomile.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Your body uses several liver enzymes to clear mirtazapine, and one of them is called CYP2D6. In lab studies, German chamomile appears to slow that enzyme down a bit. If that held true in people, mirtazapine could build up a little more than usual. Since mirtazapine is the active drug itself (not a prodrug that needs switching on), higher levels would mean stronger effects, things like extra drowsiness, increased appetite, or feeling groggy in the morning.

Here's the reassuring part: this is only seen in test-tube research, not in real patients, and chamomile tea is a pretty gentle exposure. I wouldn't lose sleep over an occasional cup. Still, if you plan to use chamomile regularly or in concentrated supplement form, mention it to your pharmacist or doctor so they can keep an eye on how you feel.

References
  1. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Mirtazapine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your body uses an enzyme called CYP3A4 to help clear mirtazapine. German chamomile, in lab dishes, has shown it might slow that enzyme down a bit. If that happened in real life, mirtazapine could build up slightly and you might feel more of its usual effects, things like drowsiness, grogginess in the morning, increased appetite, or dizziness.

That said, I want to keep this in perspective. This is only test-tube evidence, and it has never actually been reported in people. A cup or two of chamomile tea is very unlikely to cause trouble. Concentrated chamomile supplements are more of a question mark. If you take mirtazapine daily, it's worth a quick chat with your pharmacist or doctor before starting one.

References
  1. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  2. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

3 of 3

Mirtazapine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, German chamomile might inhibit CYP1A2 and increase levels of drugs metabolized by these enzymes.
In vitro and animal research shows that German chamomile might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP1A2 in patients taking German chamomile.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your body uses several liver enzymes, including one called CYP1A2, to clear mirtazapine. German chamomile might slow that particular enzyme down a little. If it did, a bit more mirtazapine could linger in your system, which in theory could nudge up its usual effects, things like drowsiness, grogginess, increased appetite, or feeling more sedated than usual.

I want to be honest about how soft this is, though. This concern comes only from lab and animal studies, and it has never actually been reported in real people. A cup or two of chamomile tea at bedtime is very unlikely to cause trouble. If you take concentrated chamomile supplements or feel extra sleepy, just check in with your pharmacist or doctor.

References
  1. Maliakal PP, Wanwimolruk S. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol 2001;53:1323-9. PubMed
  2. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

German Chamomile Also Interacts With Other Medications

German Chamomile has 924 moderate, 35 minor known drug interactions in our database — the Mirtazapine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against German Chamomile

Covers the 2,830 medications we’ve checked against German Chamomile. Pick one to open its full report.

From our Q&A

Questions About German Chamomile or Mirtazapine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers German Chamomile or Mirtazapine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Mirtazapine

This page covers German Chamomile only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mirtazapine page lists 212 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), St. John's Wort (major) and 1,3-dmaa (moderate).

By severity: 4 major · 162 moderate · 46 minor.

From our pharmacist’s overview on the Mirtazapine page

“Depression and poor sleep tend to travel together, which is why people on mirtazapine (Remeron) so often eye herbal mood and sleep remedies, and that overlap is exactly where this list demands real care. Four of the 212 ingredients on file carry a major rating.”

Reviewed by 2 · Jul 18, 2026

Open the Mirtazapine interaction page

One more smart check

Taking German Chamomile as Part of a Dietary Supplement Product? Check It for Interactions

We hold 782 real supplement products containing German Chamomile, each one broken down to its full ingredient list — and combination products often carry several ingredients besides German Chamomile. Your product may carry other ingredients that interact with Mirtazapine too, on top of German Chamomile — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where German Chamomile and Mirtazapine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement German Chamomile
Top 25%

#239 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Mirtazapine
Top 25%

#475 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About German Chamomile

What is German Chamomile?

German Chamomile
  • Anxiety and stress
  • Sleep and relaxation
  • Digestive upset
  • Skin irritation and inflammation
  • Mouth sores and gum irritation

German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin or digestive issues, but the evidence is limited and most uses are based on tradition rather than strong proof. It is generally well tolerated, but people allergic to ragweed or related plants and those who are pregnant should be cautious.

Read the full German Chamomile monograph & all interactions
Medication

About Mirtazapine

What Is Mirtazapine Used For?

Brand name: Remeron

Mirtazapine tablets, mirtazapine orally disintegrating tablets, Remeron, and RemeronsолTab are all indicated for the treatment of major depressive disorder (MDD) in adults. Major depressive disorder involves a persistently low or sad mood most days, often accompanied by loss of interest, sleep changes, fatigue, and difficulty concentrating.

The effectiveness of mirtazapine tablets in maintaining a response for up to 40 weeks after an initial treatment period has also been demonstrated. Patients should be reassessed periodically to determine whether continued treatment is needed.

See full Mirtazapine drug information
Keep checking

Other Drugs & German Chamomile

Browse every other medication we’ve checked against German Chamomile — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
924Moderate
35Minor
1,870No known interaction
Moderate

924 interactions

Showing 60 of 924 moderate interactions — see all 924 on the German Chamomile page.

Minor

35 interactions

No interaction 1,870 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking German Chamomile and Mirtazapine Together: Common Questions

Can you take German Chamomile with Mirtazapine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for German Chamomile and Mirtazapine?
Mirtazapine belongs to more than one drug category, and German Chamomile interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the German Chamomile and Mirtazapine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Mirtazapine and German Chamomile?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.