Pronunciation: mir-TAZ-a-peen
Generic Name: Mirtazapine
Brand Name: Remeron
Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using Mirtazapine outweigh the risks.
Families and caregivers must closely watch patients who take Mirtazapine. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.
Mirtazapine is used for:
Treating depression. It may also be used for other conditions as determined by your doctor.
Mirtazapine is a tetracyclic antidepressant. Exactly how Mirtazapine improves depression symptoms is not known. It is thought to increase the activity of certain chemicals in the brain (eg, norepinephrine, serotonin) that help improve mood.
Do NOT use Mirtazapine if:
- you are allergic to any ingredient in Mirtazapine
- you are taking furazolidone
- you are taking oxitriptan or tryptophan
- you are taking or have taken furazolidone, linezolid, methylene blue, or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
Contact your doctor or health care provider right away if any of these apply to you.
Treatments for depression are getting better everyday and there are things you can start doing right away.
Before using Mirtazapine:
Some medical conditions may interact with Mirtazapine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have liver problems, high cholesterol, kidney problems, heart problems, blood vessel problems, or a low white blood cell count
- if you have a history of dizziness or fainting, seizures, heart attack, angina (chest pain), or stroke
- if you have low blood pressure, low blood volume, low blood sodium levels, or you are dehydrated
- if you have a history of mental or mood problems (eg, depression, bipolar disorder) or suicidal thoughts or behaviors
- if you take medicine to treat high blood pressure
Some MEDICINES MAY INTERACT with Mirtazapine. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Fluvoxamine, furazolidone, linezolid, lithium, MAOIs (eg, phenelzine), methylene blue, oxitriptan, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), serotonin 5-HT1 receptor agonists (eg, sumatriptan), serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, venlafaxine), St. John's wort, tramadol, tryptophan, or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of serotonin syndrome, including increased risk of restlessness, fever, excessive sweating, twitching, and seizures that can, rarely, be life-threatening
- Azole antifungals (eg, ketoconazole), benzodiazepines, (eg, diazepam), cimetidine, HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, erythromycin), or nefazodone because it may increase the risk of Mirtazapine's side effects
- Carbamazepine, phenytoin, or rifampin because they may decrease Mirtazapine's effectiveness
- Warfarin because the risk of its side effects may be increased by Mirtazapine
- Clonidine because its effectiveness may be decreased by Mirtazapine
This may not be a complete list of all interactions that may occur. Ask your health care provider if Mirtazapine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Mirtazapine:
Use Mirtazapine as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Mirtazapine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Mirtazapine refilled.
- Take Mirtazapine by mouth with or without food.
- Take Mirtazapine in the evening before bedtime unless your doctor tells you otherwise.
- Improvement should be noticed within 1 to 4 weeks of taking Mirtazapine.
- Continue to take Mirtazapine even if you feel well. Do not miss any doses.
- Do not suddenly stop taking Mirtazapine without checking with your doctor. Side effects may occur. They may include abnormal dreams, numbness or tingling, confusion, dizziness, fatigue, mental or mood changes (eg, agitation, anxiety), headache, nausea, sweating, tremor, or vomiting. If you need to stop taking Mirtazapine, your doctor will slowly lower your dose.
- If you miss a dose of Mirtazapine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Mirtazapine.
Important safety information:
- Mirtazapine may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Mirtazapine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not drink alcohol while you are taking Mirtazapine.
- Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Mirtazapine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause these effects.
- Mirtazapine may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Children, teenagers, and young adults who take Mirtazapine may be at increased risk for suicidal thoughts or actions. Watch all patients who take Mirtazapine closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
- Serotonin syndrome is a possibly fatal syndrome that can be caused by Mirtazapine. Your risk may be greater if you take Mirtazapine with certain other medicines (eg, antidepressants, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; irritability; fever; fast or irregular heartbeat; tremor; excessive sweating; rigid muscles; severe headache or dizziness; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
- Lab tests, including liver function, kidney function, and complete blood cell counts, may be performed while you use Mirtazapine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use Mirtazapine with caution in the ELDERLY; they may be more sensitive to its effects, especially drowsiness, confusion, or low blood sodium levels.
- Mirtazapine should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Mirtazapine while you are pregnant. It is not known if Mirtazapine is found in breast milk. If you are or will be breast-feeding while you use Mirtazapine, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of Mirtazapine:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Abnormal dreams; abnormal thinking; constipation; dizziness; drowsiness; dry mouth; flu symptoms; increased appetite; weakness; weight gain.
Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); mouth sores; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, trouble sleeping, restlessness, or inability to sit still; red, swollen, blistered, or peeling skin; seizures; severe headache or dizziness; sluggishness; suicidal thoughts or actions; symptoms of infection (eg, fever, chills, sore throat); tremors; unusual or severe mental or mood changes; worsening of depression.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
See also: Mirtazapine side effects (in more detail)
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include agitation; disorientation; drowsiness or deep sleep; fast heartbeat; impaired memory; loss of consciousness; rigid muscles; sluggishness.
Proper storage of Mirtazapine:
Store Mirtazapine at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Mirtazapine out of the reach of children and away from pets.
General information:
- If you have any questions about Mirtazapine, please talk with your doctor, pharmacist, or other health care provider.
- Mirtazapine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information is a summary only. It does not contain all information about Mirtazapine. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
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 Professional Patient Advice (Wolters Kluwer)
- Mirtazapine Monograph (AHFS DI)
- mirtazapine Advanced Consumer (Micromedex) - Includes Dosage Information
- Remeron Prescribing Information (FDA)
- Remeron Consumer Overview
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