Mirtazapine (Antidepressant)

Question 1

What are the brand names of mirtazapine?

Answer 1

Remeron

Question 2

What strength mirtazapine tablets are available?

Answer 2

7.5 mg, 15 mg, 30 mg, 45 mg

Question 3

What strength mirtazapine ODT tablets are available?

Answer 3

15mg, 30 mg, 45 mg

Question 4

What is the approved indication and dosage of Remeron?

Answer 4

• Indicated for the treatment of depression.
• The recommended starting dose is 15 mg per day given in a single dose, preferably at bedtime. Maintenance dose range is 15 to 45 mg per day. Dosage changes should occur at intervals of 1 to 2 weeks due to Remeron’s long elimination half-life.

Question 5

What is the mechanism of action for mirtazapine?

Answer 5

The mechanism of action 0f mirtazapine may be due to its action as an antagonist of central presynaptic alpha-2 adrenergic inhibitory autoreceptors and heteroreceptors, an action that is postulated to result in an increase in noradrenergic and seretonergic activity.

Question 6

What are the drug interactions of mirtazapine?

Answer 6

• May have additive effect with CNS depressant drugs.
• Combination with MAO inhibitor’s may result in serious and sometimes fatal reactions.
• Coadministration with aspirin or NSAIDs may increase the risk of upper G.I. bleeding

Question 7

What are the contraindications of Remeron?

Answer 7

• Antidepressants increase suicidal thoughts and actions in children, adolescents, and young adults.
• Rare cases of agranulocytosis have occurred during treatment.
• If a patient develops a sore throat, fever, stomatitis, or other signs of infection, along with a low WBC, treatment should be discontinued and the patient monitored.
• Do not use with a mega inhibitors or within 14 days of initiating or discontinuing MAO I therapy. Patient at high risk of suicide should be supervised during initiation of therapy.
• Abrupt discontinuation of therapy may cause adverse effects including dysphoric mood, irritability, agitation, dizziness, anxiety, confusion, insomnia, and headache.
• Pregnancy category C

Question 8

What are the address effects of mirtazapine?

Answer 8

Drowsiness, dry mouth, increased appetite, constipation, weight gain, dizziness, fleas syndromes, and abnormal dreams.

The following adverse effects have been reported in 2% or less of patients in controlled studies: back pain, peripheral edema, myalgia, tremor, confusion, dyspnea, and urinary frequency.

Question 9

What should the pharmacist tell the patient when counseling them on the use of Remeron?

Answer 9

• Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. Antidepressants may increase suicidal thoughts or actions.
• May cause drowsiness. Use care when operating machinery or when mental alertness is required.
• Avoid alcohol while taking this medication.
• Up to two weeks maybe needed it before therapeutic effects are seen.
• Do not abruptly discontinue medication.
• Contact a physician if you develop a sore throat, fever, stomatitis, or other signs of infection.
• If a dose missed, skip it and return to normal dosing schedule.
• SoluTabs must be used immediately upon opening individual tablet blisters.