Generic Name and Formulations:
Mirtazapine 15mg+, 30mg+, 45mg, tabs; +scored.
Merck & Co., Inc.
Indications for REMERON:
Major depressive disorder.
Initially 15mg once daily at bedtime; increase at intervals of at least 1–2 weeks; max 45mg/day. SolTab: Dissolve on tongue and swallow with or without water.
During or within 14 days of MAOIs. Concomitant linezolid or IV methylene blue.
Suicidality and antidepressant drugs.
Increased risk of suicidal thinking and behavior in children, adolescents and young adults; monitor for clinical worsening or unusual changes. Screen for bipolar disorder. Risk of agranulocytosis; monitor for signs/symptoms of infection. Monitor for serotonin syndrome; discontinue if occurs. Angle-closure glaucoma. Known cardiovascular or cerebrovascular disease. History of QT prolongation. Hepatic or moderate-to-severe renal dysfunction. Diseases that affect metabolism or hemodynamic response. History of mania/hypomania. Seizure disorders. Dehydration. Hypovolemia. Avoid abrupt cessation. Elderly. Pregnancy (Cat.C). Nursing mothers.
Central alpha-2 antagonist.
See Contraindications. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Increased risk of QT prolongation and/or ventricular arrhythmias with concomitant drugs known to prolong the QTc interval (eg, certain antipsychotics or antibiotics). Concomitant diazepam: not recommended. Caution with drugs metabolized by and/or that inhibit CYP450. Avoid alcohol. Concomitant warfarin; monitor INR.
Somnolence, increased appetite, weight gain, dizziness, nausea, dry mouth, constipation, asthenia; akathisia, hypo- or hypertension, elevated cholesterol, triglycerides, or transaminases; rarely; hyponatremia (esp. elderly), agranulocytosis.
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