Mirtazapine (Systemic)
Brand Names : Remeron, Remeron SolTab
Before Using This MedicineIn deciding to use a medicine,
the risks of taking the medicine must be weighed against the good it will
do. This is a decision you and your doctor will make. For mirtazapine, the
following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to mirtazapine. Also tell your health care professional
if you are allergic to any other substances, such as foods, preservatives,
or dyes.
Pregnancy - Mirtazapine has not been studied in pregnant women.
However, this medicine has been shown to cause death of the fetus in animals
given doses many times higher than the usual human dose. Mirtazapine has not
been shown to cause birth defects in animals.
Breast-feeding - It is not known whether mirtazapine passes into
breast milk. Although most medicines pass into breast milk in small amounts,
many of them may be used safely while breast-feeding. Mothers who are taking
this medicine and who wish to breast-feed should discuss this with their doctor.
Children - Studies on this medicine have been done only in adult
patients, and there is no specific information comparing use of mirtazapine
in children with use in other age groups. Mirtazapine must be used with caution in children with depression. Studies
have shown occurrences of children thinking about suicide or attempting suicide
in clinical trials for this medicine. More study is needed to be sure mirtazapine
is safe and effective in children.
Older adults - This medicine has been tested and has not been shown
to cause different side effects or problems in older people than it does in
younger adults. However, it is removed from the body more slowly in older
people.
Other medicines - Although certain medicines should not be used
together at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your doctor may want to
change the dose, or other precautions may be necessary. When you are taking
mirtazapine, it is especially important that your health care professional
know if you are taking any of the following:
-
Alcohol or
-
Central nervous system (CNS) depressants (medicines that cause drowsiness)
or
-
Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine
[e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane],
doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g.,
Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - Using
these medicines with mirtazapine may increase the CNS depressant effects
-
Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g.,
Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline
[e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Do not take mirtazapine while you are taking, or within 2 weeks of taking,
an MAO inhibitor
or you may develop confusion, agitation, restlessness,
stomach or intestinal symptoms, sudden high body temperature, extremely high
blood pressure, and severe convulsions; at least 14 days should be allowed
between stopping treatment with one medicine and starting treatment with the
other
Other medical problems - The presence of other medical
problems may affect the use of mirtazapine. Make sure you tell your doctor
if you have any other medical problems, especially:
-
Convulsions (seizures) (history of) - Mirtazapine has been reported
to cause seizures rarely
-
Dehydration or
-
Heart disease or
-
Stroke (history of) - Mirtazapine may make the condition worse
by causing low blood pressure (hypotension)
-
Kidney disease - Effects of mirtazapine may be increased because
of slower removal from the body
-
Liver disease - Mirtazapine may cause liver problems; also, effects
of mirtazapine may be increased because of slower removal from the body
-
Mania (a type of mental illness) (or history of) - Mirtazapine
may cause this problem to recur
-
Phenylketonuria (PKU) - The oral disintegrating tablets may contain
aspartame, which can make your condition worse
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