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mirtazapine
Remeron, Zispin§

Pregnancy Risk Category C

How supplied
Tablets:
15 mg, 30 mg

Action
Antidepressant action is thought to be due to enhancement of central noradrenergic and serotonergic activity.

Indications & dosage
Depression--

Adults:
initially, 15 mg P.O. h.s. Maintenance dosage ranges from 15 to 45 mg daily. Dosage adjustments should be made at intervals of no less than 1 to 2 weeks.

Adverse reactions
CNS:
somnolence, dizziness, asthenia, abnormal dreams, abnormal thinking, tremors, confusion.
CV:
edema.
GI:
nausea, increased appetite, dry mouth, constipation.
GU:
urinary frequency.
Hepatic:
increased ALT levels.
Metabolic:
weight gain.
Musculoskeletal:
back pain, myalgia.
Respiratory:
dyspnea.
Other:
flulike syndrome, peripheral edema, increased cholesterol and triglycerides.

Interactions
Drug-drug.
Diazepam, other CNS depressants: possible additive CNS effects. Avoid concomitant use.
MAO inhibitors:
sometimes fatal reactions. Avoid concomitant use.
Drug-lifestyle.
Alcohol use: possible additive CNS effects. Avoid concomitant use.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug. Drug shouldn't be used with MAO inhibitor or within 14 days of initiating or discontinuing therapy with MAO inhibitor. At least 14 days should elapse after stopping mirtazapine before starting an MAO inhibitor.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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