MIRTAZAPINE

(mir TAZ a peen) Brand: Remeron, Remeron SolTab

What is the most significant information I must 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.

• Message 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 must not take this medicine 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 till the MAO inhibitor has cleared from your body.

• Till taking mirtazapine, speak your doctor if you have bipolar mess, liver or kidney malady, seizures, heart malady, a history of heart onslaught or stroke, or a history of drug abuse or suicidal thoughts.

• It may take up to different weeks till your symptoms improve. Hold using the medicine as directed and speak your doctor if your symptoms do not improve after 4 weeks of treatment.

• Drinking alcohol can magnify determined 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 is mirtazapine?

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

• Mirtazapine is used to treat major depressive disorder.

• Mirtazapine may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking mirtazapine?

• You must not take this medicine 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 recent 14 days. Serious, life threatening side effects can occur if you use mirtazapine till the MAO inhibitor has cleared from your body.

• To create certain you can safely take mirtazapine, speak your doctor if you have any of these another conditions:

· liver or kidney disease;

· bipolar mess (manic depression);

· seizures or epilepsy;

· low blood pressure or dizzy spells;

· tall cholesterol or triglycerides;

· heart malady, including angina (chest pain);

· a history of heart onslaught 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. Speak your doctor if you have worsening depression or suicidal thoughts during the first different weeks of treatment, or whenever your doze is changed.

• Your family or another caregivers must 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 child. Speak 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 child. Do not use this medicine without telling your doctor if you are breast-feeding a baby.

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

How must I take mirtazapine?

• Take exactly as predesigned by your doctor. Do not take in larger or less 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):

· Hold the tablet in its blister pack before you are ready to take the medication. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may interrupt the tablet.

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

· Do not swallow the tablet intact. Let it to dissolve in your mouth without chewing.

· Swallow different times as the tablet dissolves. No water is needed.

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

• It may take up to different weeks till your symptoms improve. Hold using the medicine as directed and speak 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.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

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

What must I avoid while taking mirtazapine?

• Drinking alcohol can magnify determined 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 are the possible side effects of mirtazapine?

• Get abnormal medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

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

· agitation, hallucinations, fever, quick heart course, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination;

· very stiff (rigid) muscles, tall fever, sweating, confusion, quick or uneven heartbeats, tremors;

· feeling like you might pass out;

· fever, chills, body aches, flu symptoms;

· white patches or sores internal your mouth or on your lips; or

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

• Smaller serious side effects include:

· drowsiness, dizziness;

· heighten 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 message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect mirtazapine?

• Cool or allergy medication, sedatives, narcotic pain medication, sleeping pills, muscle relaxers, and medication for seizures or anxiety can add to sleepiness caused by mirtazapine. Speak your doctor if you regularly use any of these medicines

• Much drugs can interact with mirtazapine. Adown is just a partial list. Speak 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, Pediazole), rifampin (Rifadin, Rifater, Rifamate), or telithromycin (Ketek);

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

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

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

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

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

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

• This list is not complete and another drugs may interact with mirtazapine. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about mirtazapine.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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