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Mirtazapine (By mouth)

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

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • 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.
  • Make sure your hands are dry before you handle the disintegrating tablet. Peel back the foil from the blister pack, then remove the tablet. Do not push the tablet through the foil. Place the tablet in your mouth. After it 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. Ask your pharmacist for a copy if you do not have one.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take 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  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.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 out of the reach of children. 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 drink alcohol or if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.
  • 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. Your doctor will need to slowly decrease your dose before you stop 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 do lab tests at regular visits to check on the effects of this medicine. 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


Last Updated: 4/4/2014
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