Remeron

Generic name: Mirtazapine

What is Remeron?

Remeron is a tetracyclic antidepressant used for the treatment of major depressive disorder.

What is the most important information I should know about Remeron?

Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults when the medicine is first started. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have (or have a family history of) bipolar disorder (also called manic-depressive illness) or suicidal thoughts or actions.

Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is first started or when the dose is changed.

Call the doctor right away to report new or sudden changes in mood, behavior, thoughts, or feelings. Signs to watch for include new or worsening depression, new or worsening anxiety, agitation, insomnia, hostility, panic attacks, restlessness, extreme hyperactivity, and suicidal thinking or behavior.

Keep all follow-up visits as scheduled, and call the doctor between visits as needed, especially if you have concerns about symptoms.

Do not use this medication if you have used an MAO inhibitor (such as isocarboxazid, phenelzine, rasagiline, selegiline, or tranylcypromine) within the past 14 days.

If you of your family member develops signs and symptoms of fever, sore throat, stomatitis, or other signs of infection, contact your doctor right away as this may be a sign of a serious side effect.

While you may notice improvements with Remeron therapy in 1 to 4 weeks, you should continue therapy as directed.

Never stop an antidepressant, such as Remeron, without first talking to a healthcare provider. Stopping an antidepressant medicine suddenly can cause other symptoms.

This drug may impair the mental and/or physical abilities required for performing potentially hazardous tasks such as driving or operating machinery. These effects may become worse if you combine Remeron with alcohol or certain medicines.

Who should not take Remeron?

Remeron should not be used if you are known to be hypersensitive to this medication or any of its ingredients.

Do not use Remeron if you have used an MAO inhibitor within the past 14 days.

What should I tell my doctor before I take the first dose of Remeron?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Remeron. Also, talk to your doctor about your complete medical history, especially if you have liver disease or kidney disease, a low white blood cell count, have recently taken an MAO inhibitor (such as isocarboxazid, phenelzine, rasagiline, selegiline, or tranylcypromine) within the past 14 days, or if you have attempted or thought about suicide in the past.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The recommended starting dose of Remeron is 15 milligrams (mg) daily taken as a single dose. Preferably, this dose is to be taken in the evening, prior to sleep. The effective dose range is 15 mg to 45 mg daily. Older adults and people with serious liver or kidney problems may require a lower dose. If dose changes are needed, they should not be made at intervals of less than 1-2 weeks in order to allow sufficient time for evaluation of the drug's effect.

How should I take Remeron?

Remeron should be taken exactly as prescribed. Follow the directions on your prescription label.

Take Remeron by mouth with or without food daily. Take Remeron in the evening before bedtime unless your doctor tells you otherwise.

Improvements should be noticed within 1 to 4 weeks of taking this medication. Continue to take Remeron even if you feel well, do not miss a dose.

What should I avoid while taking Remeron?

Avoid driving or operating potentially dangerous machinery. Do not participate in any activities that require full alertness until you know how this drug affects you.

Avoid drinking alcohol. It can cause dangerous side effects when taken with Remeron.

Do not use Remeron if you have used an MAO inhibitor (such as isocarboxazid, phenelzine, rasagiline, selegiline, or tranylcypromine) within the past 14 days.

What are possible food and drug interactions associated with Remeron?

If Remeron is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Remeron with the following: alcohol, clonidine, fluvoxamine, furazolidone, MAO inhibitors (including Nardil and Parnate), and hydantoins such as phenytoin.

What are the possible side effects of Remeron?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: abnormal dreams, abnormal thinking, constipation, dizziness, drowsiness, dry mouth, flu symptoms, increased appetite, weakness, weight gain, decreased ability to fight infection (fever, chill, sore throat), mental or mood changes, mouth sores, thoughts or hurting yourself, tremors, worsening of depression

Can I receive Remeron if I am pregnant or breastfeeding?

The effects of Remeron during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Remeron?

If you do miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not double the dose.

How should I store Remeron?

Store at room temperature away from heat, moisture, and light. Do not store in the bathroom.