mirtazapine, Remeron, Soltab

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Understanding Depression Slideshow

What is mirtazapine, and how does it work (mechanism of action)?

Mirtazapine is a tetracyclic antidepressant similar to maprotiline (Ludiomil) and tricyclic antidepressants, for example, desipramine (Norpramin). Depression is an all-pervasive sense of sadness and gloom. It is believed that in some patients with depression, abnormal levels of neurotransmitters (chemicals that nerves use to communicate with each other) may be the cause of their depression. Mirtazapine elevates mood by raising the level of neurotransmitters (norepinephrine and serotonin) in nerves of the brain. Mirtazapine also blocks the effect of histamine. Mirtazapine was approved by the FDA in 1996.

What brand names are available for mirtazapine?

Remeron, Remeron SolTab

Is mirtazapine available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for mirtazapine?

Yes

What are the side effects of mirtazapine?

The most common side effects of mirtazapine include drowsiness,

Other important side effects that could potentially be serious include

Quick GuidePhysical Symptoms of Depression in Pictures

Physical Symptoms of Depression in Pictures

What is the dosage for mirtazapine?

The usual starting dose for mirtazapine is 15 mg once daily, usually at bedtime. Doses may be increased every 1-2 weeks up to a maximum dose of 45 mg daily. It may be taken with or without food.

Which drugs or supplements interact with mirtazapine?

Mirtazapine adds to the sedating effects of alcohol and other drugs that can cause sedation such as:

Fluvoxamine (Luvox), ketoconazole (Nizoral) and cimetidine (Tagamet) may increase the levels of mirtazapine in the blood which may lead to increased side effects from mirtazapine. Carbamazepine (Tegretol) and phenytoin (Dilantin) decrease the blood concentration of mirtazapine by increasing the breakdown of mirtazapine in the liver, possibly reducing the effect of mirtazapine.

Mirtazapine should not be used with monoamine oxidase (MAO) inhibiting drugs such as phenelzine (Nardil), procarbazine (Matulane), selegiline (Eldepryl), or tranylcypromine (Parnate). High fever, convulsions, and even death can occur from such combinations. Therefore, an interval of 14 days is recommended between stopping MAO inhibitor therapy and starting mirtazapine, and vice versa. Similar reactions may occur if mirtazapine is combined with other drugs that increase serotonin activity in the brain. Such drugs to avoid include tryptophan, sumatriptan (Imitrex), linezolid (Zyvox), fluoxetine (Prozac), venlafaxine (Effexor), lithium (Eskalith, Lithobid), tramadol (Ultram), and St. John's wort.

Is mirtazapine safe to take if I'm pregnant or breastfeeding?

There are no adequate studies of mirtazapine in pregnant women. Thus, physicians must balance potential benefits against potential risks when considering mirtazapine therapy in pregnant women.

It is not known if mirtazapine is secreted in breast milk.

What else should I know about mirtazapine?

What preparations of mirtazapine are available?

Tablet (Orally disintergrating): 15, 30, and 45 mg

How should I keep mirtazapine stored?

Tablets should be stored at room temperature, 15-30 C (59-86 F).

REFERENCES:

FDA Prescribing Information for mirtazapine

AHFS Drug Information for mirtazapine

Quick GuidePhysical Symptoms of Depression in Pictures

Physical Symptoms of Depression in Pictures

Summary

Mirtazapine (Remeron) is a tetracyclic antidepressant prescribed for the treatment of major depression and posttraumatic stress disorder (PTSD). Side effects, drug interactions, dosing information and warnings and precautions should be reviewed prior to taking any medication.

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

Subscribe to MedicineNet's Depression Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

See more info: mirtazapine on RxList
Reviewed on 12/11/2014
References
REFERENCES:

FDA Prescribing Information for mirtazapine

AHFS Drug Information for mirtazapine

Health Solutions From Our Sponsors