mirtazapine
 

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mirtazapine



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Generic Name: mirtazapine (mir TAZ a peen)
Brand Names: Remeron, Remeron SolTab

What is mirtazapine?

Mirtazapine is an antidepressant. Mirtazapine affects chemicals in the brain that may become unbalanced and cause depression.

Mirtazapine is used to treat major depressive disorder.

Mirtazapine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about mirtazapine?

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. You should not take this medication if you are allergic to mirtazapine or if you are also taking tryptophan (sometimes called L-tryptophan). Do not use mirtazapine if you have used an MAO inhibitor within the past 14 days. Serious, life-threatening side effects can occur if you take mirtazapine before the MAO inhibitor has cleared from your body.

Before taking mirtazapine, tell your doctor if you have bipolar disorder, liver or kidney disease, seizures, heart disease, a history of heart attack or stroke, or a history of drug abuse or suicidal thoughts.

Video: Treatment for Depression

Treatments for depression are getting better everyday and there are things you can start doing right away.

It may take up to several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment. Drinking alcohol can increase certain side effects of mirtazapine. Mirtazapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. What should I discuss with my healthcare provider before taking mirtazapine? You should not take this medication if you are allergic to mirtazapine or if you are also taking tryptophan (sometimes called L-tryptophan). Do not use mirtazapine if you have taken an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use mirtazapine before the MAO inhibitor has cleared from your body.

To make sure you can safely take mirtazapine, tell your doctor if you have any of these other conditions:

liver or kidney disease;

bipolar disorder (manic depression);

seizures or epilepsy;

low blood pressure or dizzy spells;

high cholesterol or triglycerides;

heart disease, including angina (chest pain);

a history of heart attack or stroke; or

a history of drug abuse or suicidal thoughts.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. It is not known whether mirtazapine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether mirtazapine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The orally disintegrating tablet may contain phenylalanine. Talk to your doctor before using this form of mirtazapine if you have phenylketonuria (PKU).

How should I take mirtazapine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take the regular tablet form of mirtazapine with water.

To take mirtazapine orally disintegrating tablets (Remeron SolTab):

Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may break the tablet.

Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Swallow several times as the tablet dissolves. No water is needed.

Mirtazapine is usually taken once a day at bedtime. Follow your doctor's instructions.

It may take up to several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment. Do not stop using mirtazapine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using mirtazapine. Store at room temperature, away from moisture and heat.

See also: Mirtazapine dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include confusion, memory problems, drowsiness, and fast heart rate.

What should I avoid while taking mirtazapine? Drinking alcohol can increase certain side effects of mirtazapine. Mirtazapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Mirtazapine side effects Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;

fever, chills, body aches, flu symptoms;

white patches or sores inside your mouth or on your lips; or

headache, trouble concentrating, memory problems, weakness, feeling unsteady, or confusion.

Less serious side effects include:

drowsiness, dizziness;

increased appetite; or

weight gain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Mirtazapine Dosing Information

Usual Adult Dose for Depression:

Initial dose: 15 mg orally once a day at bedtime.
Maintenance dose: 15 to 45 mg per day.

What other drugs will affect mirtazapine? Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by mirtazapine. Tell your doctor if you regularly use any of these medicines

Many drugs can interact with mirtazapine. Below is just a partial list. Tell your doctor if you are using:

cimetidine (Tagamet);

conivaptan (Vaprisol);

imatinib (Gleevec);

isoniazid (for treating tuberculosis);

lithium (Eskalith, LithoBid);

St. John's wort;

tramadol (Ultram, Ultracet);

a blood thinner such as warfarin (Coumadin, Jantoven);

an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), rifampin (Rifadin, Rifater, Rifamate), or telithromycin (Ketek);

an antidepressant such as amitriptyline (Elavil, Vanatrip), citalopram (Celexa), doxepin (Sinequan), desipramine (Norpramin), desvenlafaxine (Pristiq), fluoxetine (Prozac, Sarafem, Symbyax), imipramine (Janimine, Tofranil), nefazodone, nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), venlafaxine (Effexor), and others;

antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), or miconazole (Oravig);

heart or blood pressure medication such as nicardipine (Cardene) or quinidine (Quin-G);

HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir);

migraine headache medicine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), or zolmitriptan (Zomig);

seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol) or phenytoin (Dilantin);

This list is not complete and other drugs may interact with mirtazapine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More mirtazapine resources Mirtazapine Side Effects (in more detail) Mirtazapine Dosage Mirtazapine Use in Pregnancy & Breastfeeding Drug Images Mirtazapine Drug Interactions Mirtazapine Support Group 127 Reviews for Mirtazapine - Add your own review/rating mirtazapine Advanced Consumer (Micromedex) - Includes Dosage Information Mirtazapine MedFacts Consumer Leaflet (Wolters Kluwer) Mirtazapine Professional Patient Advice (Wolters Kluwer) Mirtazapine Monograph (AHFS DI) Remeron Prescribing Information (FDA) Remeron Consumer Overview Remeron SolTab Orally Disintegrating Tablets MedFacts Consumer Leaflet (Wolters Kluwer) Compare mirtazapine with other medications Anxiety Depression Hot Flashes Insomnia Post Traumatic Stress Disorder Where can I get more information? Your pharmacist can provide more information about mirtazapine.

See also: mirtazapine side effects (in more detail)







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