Mirtazapine (By mouth)

Introduction

Mirtazapine (mir-TAZ-a-peen)

Treats depression. This medicine is an antidepressant.

Brand Name(s)

Remeron, Remeron Soltab

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

Do not use this medicine if you have had an allergic reaction to mirtazapine. Do not use this medicine and an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, Parnate®, or linezolid (Zyvox®) within 14 days of each other.

How to Use This Medicine

Tablet, Dissolving Tablet

  • Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
  • Your doctor may tell you to take the medicine at bedtime, because mirtazapine can make you sleepy.
  • You may need to take this medicine for several weeks before you begin to feel better.
  • If you are using the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet in your mouth. It should melt quickly. After the tablet has melted, swallow or take a drink of water. Do not crush, split, or break the tablet.
  • This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep the orally disintegrating tablet in the original package until you are ready to take it.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you use St John's wort, buspirone (Buspar®), fentanyl (Sublimaze®), lithium (Eskalith®, Lithobid®), tramadol (Ultram®), tryptophan, other medicine to treat depression (such as citalopram, fluoxetine, nefazodone, nortriptyline, sertraline, Cymbalta®, Effexor®, Lexapro®, Pristiq®, Serzone®), or medicine to treat migraine headache (such as sumatriptan, Frova®, Maxalt®, Relpax®, Zomig®).
  • Tell your doctor if you also use carbamazepine (Tegretol®), cimetidine (Tagamet®), diazepam (Valium®), erythromycin (Ery-Tab®), phenytoin (Dilantin®), rifampicin (Rifadin®, Rimactane®), medicine to treat high blood pressure (such as amlodipine, atenolol, clonidine, hydrochlorothiazide, lisinopril, metoprolol, Benicar®, Cozaar®, Diovan®), medicine to treat fungal infection (such as itraconazole, ketoconazole, Nizoral®), medicine to treat HIV/AIDS (such as atazanavir, lopinavir, ritonavir, Crixivan®, Kaletra®, Lexiva®, Norvir®, Prezista®, Reyataz®), or a blood thinner (such as warfarin, Coumadin®, Jantoven®).
  • Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding or if you have kidney disease, liver disease, high cholesterol, low sodium in the blood, mania, or a history of seizures. Tell your doctor if you have any kind of heart or circulation problems, including low blood pressure, or a history of a heart attack or stroke.
  • This medicine can increase thoughts of suicide. Although this is a risk for all patients, it is more likely to occur in children, teenagers, and young adults. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or getting worse quickly. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
  • This medicine can increase your risk for infection. Check with your doctor right away if you think you have been exposed to an infection or if you have a fever or chills, sore throat, mouth sores, lower back or side pain, or painful or difficult urination.
  • Check with your doctor right away if you are having agitation, tremors, trouble breathing, fast heartbeat, hallucinations, high fever, increased sweating, loss of coordination, vomiting, or diarrhea while you are taking this medicine. These may be symptoms of a life-threatening reaction to this medicine.
  • Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
  • This medicine may make you dizzy or drowsy. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded or dizzy.
  • The orally disintegrating tablet contains phenylalanine. Tell your doctor if you have phenylketonuria (PKU) before you take the tablet.
  • Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Anxiety, irritability, restlessness, or trouble sleeping
  • Blistering, peeling, or red skin rash
  • Change in how much or how often you urinate
  • Fast, slow, or uneven heartbeat or chest pain
  • Fever, chills, cough, sore throat, or body aches
  • Lightheadedness, dizziness, or fainting
  • Nausea, vomiting, or diarrhea
  • Problems with coordination, muscle twitching, or tremors
  • Sores or white patches on your lips, mouth, or throat
  • Swelling in your hands, ankles, or feet
  • Unusual behaviors or thoughts of hurting yourself or others
  • Unusual tiredness or weakness

If you notice these less serious side effects, talk with your doctor:

  • Constipation
  • Dry mouth or thirst
  • Increased appetite or weight gain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: June 18, 2013

         
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