Mirtazapine

What it is used for

Mirtazapine tablets are indicated for the treatment of major depressive disorder (MDD) in adults. Mirtazapine tablets are indicated for the treatment of major depressive disorder (MDD) in adults.

The most important thing to know

Mirtazapine tablets may cause serious side effects, including: Increased risk of suicidal thoughts or actions in some children and young adults. Mirtazapine tablets, and other antidepressant medicines may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.

Mirtazapine tablets are not for use in children. Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. How can I watch for and try to prevent suicidal thoughts and actions? Pay close attention to any changes, especially sudden changes in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions.

This is very important when an antidepressant medicine is started or when the dose is changed. Call your healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms.

Call your healthcare provider or get emergency medical help right away if you or your family member have any of the following symptoms, especially if they are new, worse, or worry you: attempts to commit suicide acting on dangerous impulses acting aggressive, being angry or violent thoughts about suicide or dying new or worse depression new or worse anxiety panic attacks feeling very agitated or restless new or worse irritability trouble sleeping an extreme increase in activity or talking (mania) other unusual changes in behavior or mood What are mirtazapine tablets?

Mirtazapine tablets are prescription medicines used to treat a certain type of depression called Major Depressive Disorder (MDD) in adults. It is not known if mirtazapine tablets are safe and effective for use to treat MDD in children.

How to take it

Take mirtazapine tablets exactly as your healthcare provider tells you to. Do not change your dose or stop taking mirtazapine tablets without first talking to your healthcare provider. Your healthcare provider may need to change the dose of mirtazapine tablets until it is the right dose for you. Take mirtazapine tablets 1 time each day, preferably in the evening at bedtime.

If you take too much mirtazapine call your healthcare provider or poison control center at 1-800-222-1222 right away or go to the nearest hospital emergency room.

Side effects, and when to stop

” Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

Who should not take it

Do not take mirtazapine tablets if you: take a Monoamine Oxidase Inhibitor (MAOI) have stopped taking an MAOI in the last 14 days are being treated with the antibiotic linezolid or intravenous methylene blue if you are allergic to mirtazapine or any of the ingredients in mirtazapine tablets. See the end of this Medication Guide for a complete list of ingredients in mirtazapine tablets.

Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid or intravenous methylene blue. Do not start taking an MAOI for at least 14 days after you stop treatment with mirtazapine tablets. Before taking mirtazapine tablets, tell your healthcare provider about all your medical conditions, including if you: have a history of suicide or depression have a history or family history of bipolar disorder, mania or hypomania have a low white blood cell count have glaucoma (high pressure in the eye) have or had heart problems or stroke have an abnormal heart beat called QT prolongation or a family history of QT prolongation have seizures have high cholesterol or triglyceride levels have low sodium levels in your blood have or had kidney or liver problems have low blood pressure are pregnant or plan to become pregnant.

It is not known if mirtazapine tablets will harm your unborn baby. Talk to your healthcare provider if you become pregnant or think you may be pregnant during treatment with mirtazapine tablets. are breastfeeding or plan to breastfeed. Mirtazapine may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with mirtazapine tablets.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Mirtazapine tablets and other medicines may affect each other causing possible serious side effects. Mirtazapine tablets may affect the way other medicines work and other medicines may affect the way mirtazapine and mirtazapine tablets work.

Especially tell your healthcare provider if you take: MAOIs medicines to treat migraine headaches known as triptans tricyclic antidepressants fentanyl lithium tramadol tryptophan buspirone amphetamines benzodiazepines St. John’s Wort medicines used to treat mood, anxiety, psychotic or thought disorders, including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) medicines that may affect your heart rhythm (such as certain antibiotics and some antipsychotics) Ask your healthcare provider if you are not sure if you are taking any of these medicines.

Your healthcare provider can tell you if it is safe to take mirtazapine tablets with your other medicines. Do not start or stop any other medicines during treatment with mirtazapine tablets without talking to your healthcare provider first. Stopping mirtazapine tablets suddenly may cause you to have serious side effects.

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What to avoid

Do not drive, operate heavy machinery, or do other dangerous activities until you know how mirtazapine tablets affects you. Mirtazapine tablets can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. Avoid drinking alcohol during treatment with mirtazapine tablets. Avoid taking medicines used to treat anxiety, insomnia, and seizures, called benzodiazepines, during treatment with mirtazapine tablets.

Ask your healthcare provider if you are not sure if you take one of these medicines. What are the possible side effects of mirtazapine tablets? Mirtazapine tablets may cause serious side effects, including: See, “What is the most important information I should know about mirtazapine tablets?” Low white blood cell count.

Tell your healthcare provider right away if you develop any signs or symptoms of a low white blood cell count, including: fever chills sore throat mouth or nose sores flu-like symptoms infections Serotonin syndrome. A potentially life-threatening problem called serotonin syndrome can happen when you take mirtazapine tablets with certain other medicines.

See, “Who should not take mirtazapine tablets?” Stop taking mirtazapine tablets and call your healthcare provider or go to the nearest hospital emergency room right away if you have any of the following signs and symptoms of serotonin syndrome: agitation seeing or hearing things that are not real (hallucinations) confusion coma fast heart beat blood pressure changes dizziness sweating flushing high body temperature (hyperthermia) tremors, stiff muscles, or muscle twitching loss of coordination seizures nausea, vomiting, diarrhea Eye problems (angle-closure glaucoma).

Mirtazapine tablets may cause a certain type of eye problem called angle-closure glaucoma. Call your healthcare provider if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.

Heart rhythm problems. Increased appetite and weight gain. Sleepiness. See, “What should I avoid while taking mirtazapine tablets?” Mania or hypomania (manic episodes) in people who have a history of bipolar disorder. Symptoms may include: greatly increased energy severe trouble sleeping racing thoughts reckless behavior unusually grand ideas excessive happiness or irritability talking more or faster than usual Seizures (convulsions).

Increased fat levels (cholesterol and triglycerides) in your blood. Low sodium levels in your blood (hyponatremia). Low sodium levels in your blood may be serious and may cause death. Elderly people may be at greater risk for this. Signs and Symptoms of low sodium levels in your blood may include: headache difficulty concentrating memory changes confusion weakness and unsteadiness on your feet which can lead to falls In severe or more sudden cases, signs and symptoms include: hallucinations (seeing or hearing things that are not real) fainting seizures coma respiratory arrest death Changes in liver function tests.

Discontinuation syndrome. Suddenly stopping mirtazapine tablets may cause you to have serious side effects. Your healthcare provider may want to decrease your dose slowly. Symptoms may include: dizziness nausea and vomiting headache irritability and agitation problems sleeping abnormal dreams anxiety tiredness changes in your mood sweating confusion hypomania seizures electric shock sensation (paresthesia) ringing in your ears (tinnitus) shaking (tremor) The most common side effects of mirtazapine tablets include: sleepiness increased appetite weight gain dizziness These are not all the possible side effects of mirtazapine tablets.

Call your doctor for medical advice about side effects. You may report side

Storing it

Store mirtazapine tablets at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F). Keep mirtazapine tablets away from light and moisture. Keep mirtazapine tablets, and all medicines out of the reach of children.