 |
Indication & Dosage |
| |
| |
| Oral |
| TREATMENT OF DEPRESSION |
| Adult:
Initially, 15 mg daily; may be increased gradually depending on clinical response. Change dose at intervals of at least 1-2 wk. Usual effective dose: 15-45 mg daily given as single dose, preferably at bedtime, or in 2 divided doses. |
|
| |
|
| Administration |
May be taken with or without food. |
| |
|
| Precautions |
Epilepsy or history of seizures; avoid completely in unstable cases. Hepatic or renal impairment, cardiac disorders e.g. conduction disturbances, angina pectoris, recent MI. Hypotension, DM, psychoses, history of bipolar disorder. Stop treatment if jaundice develops. Micturition disturbances, angle-closure glaucoma, raised intraocular pressure. Monitor patient for signs of bone marrow depression. Monitor patient for suicidal tendency. Avoid abrupt withdrawal. May impair ability to drive or operate machinery. Pregnancy and lactation. Elderly. |
| |
|
| Adverse Drug Reactions |
Increase in appetite and wt, oedema; drowsiness or sedation; dizziness, headache, increased liver enzyme levels; jaundice. Orthostatic hypotension, rash, nightmares, agitation, mania, hallucinations, paraesthesia, convulsions, tremor, myoclonus, akathisia, restless legs syndrome, arthralgia, myalgia, reversible agranulocytosis, leucopenia, granulocytopenia, hyponatraemia. |
| |
|
| Interactions |
Do not use with or within 2 wk of stopping an MAOI; at least 1 wk should elapse between discontinuing mirtazapine and initiating any drug which may provoke a serious reaction (e.g. phenelzine). Potentiation of sedative effects with alcohol or benzodiazepines. Increased plasma levels with potent CYP3A4 inhibitors (e.g. HIV-protease inhibitors, azole antifungals including ketoconazole, erythromycin, nefazodone). Reduced plasma levels with carbamazepine and other inducers of CYP3A4. Increased bioavailability with cimetidine. |
| |
|
|
|
