Mirtazapine affects chemicals in the brain that may become unbalanced and cause depression. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Patients receiving continued remeron treatment experienced significantly lower relapse rates over the subsequent 40 weeks compared to those receiving placebo.
While the relationship between dose and satisfactory response in the treatment of major depressive disorder for remeron has not been adequately explored, patients not responding to the initial 15-mg dose may benefit from dose increases up to a maximum of 45 mgday. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24 there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. The mean mirtazapine dose for patients who completed these 4 studies ranged from 21 to 32 mgday.
Remeron (mirtazapine) tablets, compared to 18 for placebo and 60 for. The frequencies presented, therefore, represent the proportion of the 2796 patients exposed to multiple doses of remeron who experienced an event of the type cited on at least 1 occasion while receiving remeron. In a fertility study in rats, mirtazapine was given at doses up to 100 mgkg 20 times the maximum recommended human dose (mrhd) on an mgm basis.
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. Do not take two doses of remeron at the same time. Do not stop taking or change the dose of remeron without first talking to your doctor, even if you feel better.
The clearance of mirtazapine is reduced in elderly patients and in patients with moderate to severe renal or hepatic impairment. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information multum provides. It may take up to several weeks before your symptoms improve.
Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions adverse events are those occurring on 1 or more occasions in at least 1100 patients events are those occurring in fewer than 11000 patients. Snris and ssris, including remeron, alone but particularly with concomitant use of other serotonergic drugs (including triptans, of serotonin (in particular, maois, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue). It is common for antidepressant medicines such as remeron to take up to a few weeks before you start to feel better. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Events of major clinical importance are also described in the warnings and precautions sections.
Do not give remeron to other people, even if they have the same symptoms that you have. Remeron may impair judgment, thinking, and particularly, motor skills, because of its prominent effect. Patients should be monitored for these and other symptoms when discontinuing treatment or during dosage reduction. However, in rats, there was an increase in postimplantation losses in dams treated with mirtazapine. Patients with major depressive disorder (mdd), both adult and pediatric, may experience worsening of their depression andor the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking occurs.
The efficacy of remeron in maintaining a response in patients with major depressive disorder for up to 40 weeks following 8 to 12 weeks of initial open-label treatment was demonstrated in a placebocontrolled trial. The differences were most striking in males, with a 40 lower clearance in elderly males compared to younger males, while the clearance in elderly females was only 10 lower compared to younger females. Therapy with remeron may be resumed 24 hours after the last dose of linezolid or intravenous methylene blue (see the risk of administering methylene blue by non-intravenous routes (such as oral tablets or by local injection) or in intravenous doses much lower than 1 mgkg with remeron is unclear. Torsades de pointes) may be increased with concomitant use of medicines which prolong the qtc interval (e. Remeron is supplied for oral administration as scored film-coated tablets containing 15 or 30 mg of mirtazapine, and unscored film-coated tablets containing 45 mg of mirtazapine.
Similarly, the cited frequencies cannot be compared with figures obtained from other investigations involving different treatments, uses, and investigators. Remeron should be used with caution in patients with known filtration rate (gfr)11 - 39 mlmin1. The use of monoamine oxidase inhibitors (maois) intended to treat psychiatric disorders with remeron tablets or within 14 days of stopping treatment with remeron is contraindicated because of an increased risk of starting remeron in a patient who is being treated with maois such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome (see the mechanism of action of remeron (mirtazapine) tablets, as with other drugs effective in the treatment of major depressive disorder, is unknown. Safety and effectiveness in the pediatric population have not been established (see ). Severe allergic reactions trouble breathing, swelling of the face, tongue, eyes or mouth rash, itchy welts (hives) or blisters, alone or with fever or joint pain children and adolescents should have height and weight monitored during treatment. Prolongation in qtc 500 msec was not observed among mirtazapine-treated patients mean change in qtc was 1. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. 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 medication such as itraconazole (sporanox), ketoconazole (nizoral), or miconazole (oravig) heart or blood pressure medication such as nicardipine (cardene) or quinidine (quin-g) hivaids medicine such as atazanavir (reyataz), delavirdine (rescriptor), indinavir (crixivan), nelfinavir (viracept), saquinavir (invirase), or ritonavir (norvir, kaletra) 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. Induction of lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion, or in symptomatic patients. You can ask your pharmacist or healthcare provider for information about remeron that is written for healthcare professionals.Remeron (mirtazapine) is an antidepressant used to treat major depressive disorder. Includes Remeron side effects, interactions and indications.