Generic
Mirtazapine
37 brands available in the market
At a glance
Mirtazapine is an antidepressant used for the treatment of major depressive disorder.
Description
Mirtazapine is a tetracyclic antidepressant that enhances noradrenergic and serotonergic activity through blockade of central presynaptic adrenergic alpha 2-receptors.
Indications
- Major Depressive Disorder (MDD)
- Depression
Therapeutic class
Atypical anti-depressant drugs
Pharmacological class
Tetracyclic Antidepressant
Pharmacology
Mirtazapine acts as an antagonist at central presynaptic α2-adrenergic inhibitory autoreceptors and heteroreceptors increasing noradrenergic and serotonergic activity.
Mechanism of action
Increases noradrenergic and serotonergic activity in the brain to treat depression.
Dosage
Adult Dose (Oral):
- Initial Dose: 15 mg/day (at bedtime)
- Maintenance: 15-45 mg/day (single dose or 2 divided doses)
- Elderly: 7.5 mg/day (at bedtime); gradual increase; Max 45 mg/day
Child Dose: Safety and efficacy not established.
Administration
- May be taken with or without food
- Swallow tablet whole
- Take at the same time each day (preferably at bedtime)
Missed dose
If you miss a dose take it as soon as you remember; skip if its almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Drowsiness and somnolence
- Dry mouth
- Increased appetite and weight gain
- Headache
- Dizziness
Precautions & warnings
- Caution while driving (may cause drowsiness and dizziness)
- Do not stop abruptly (taper dose over 4 weeks)
- Avoid alcohol
- Inform doctor if sore throat or fever occurs
Contraindications
- Hypersensitivity to Mirtazapine or components
- Concomitant use with MAOI or within 14 days of MAOI discontinuation
Drug interactions
- MAOIs: Serotonin syndrome (potentially fatal)
- Alcohol and Benzodiazepines: Increased sedative effects
- CYP3A4 Inhibitors: Increased plasma levels
- Carbamazepine: Decreased plasma levels
Food interactions
Alcohol with Mirtazapine is unsafe (excessive drowsiness).
Use in pregnancy
Use in Pregnancy (Category C): Possibly unsafe. Animal studies show harmful effects.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe. May pass into breast milk and harm the baby.
Pediatric use
Safety and efficacy in children not established.
Geriatric use
Elderly dose: 7.5 mg/day (at bedtime); gradual increase; Max 45 mg/day.
Renal / hepatic impairment
Renal Impairment: (CrCl <39 mL/min): Clearance is reduced; monitor closely.
Hepatic Impairment: Clearance is reduced; monitor closely.
Overdose effects
Overdose may cause excessive sedation confusion drowsiness tachycardia.
Storage conditions
Store below 30°C away from light and moisture. Keep out of reach of children.
Chemical structure
Mirtazapine