Mirtazapine

• As per CDSCO and USFDA, Mirtazapine is an antidepressant medicine used to manage all types of depression.

When should one not use Mirtazapine

• If you are allergic to any component of this medicine.
• If you are using an MAO inhibitor or have used one in the last 14 days.
• If you have agranulocytosis (low white blood cells). This medicine can increase the chance of infection.
• If you were diagnosed with angle-closure glaucoma, an eye condition associated with increased fluid pressure inside the eye, this medicine worsens the condition.
• If you have self-harming or suicidal thoughts.
• If you have uncontrolled hypertension.
• If you have acute mania and are diagnosed with bipolar disorder.
• If you have severe heart disease such as a recent heart attack, heart rhythm problem such as long QT syndrome.
• If you have severe renal or liver impairment.
• If you have a history of seizure disorder.
• If you have low sodium levels (hyponatremia).

Common side effects of this drug are:

• Constipation
• Changes in appetite or weight
• Weakness or tiredness
• Dizziness or lightheadedness
• Decreased ability to concentrate or remember things
• Dry mouth
• Changes in sexual desire or ability

Other General Warnings

• You are over 65 years; slow metabolism in older persons increases the risk of side effects of Mirtazapine.
• You take herbal or Ayurvedic products or supplements; some of these can cause adverse effects when combined with Mirtazapine.
• You experience mood changes or thoughts of self-harming. Seek medical help immediately.
• You have planned for a surgery or a dental procedure.
• You have high blood pressure.
• You have a heart, liver or kidney disease.
• You are using medicines that increase serotonin levels.

How Does It Work?

Interactions with other medicines

• Taking Mirtazapine along with other antidepressant medications such as linezolid, diazepam, fluoxetine, etc., can cause severe adverse reactions.
• Using high doses of opioid painkillers, such as tramadol, with Mirtazapine can cause extreme drowsiness and other side effects.
• Combining Mirtazapine with blood thinners like aspirin, warfarin, etc., can increase the risk of abnormal bleeding. Monitor INR (it is a test for bleeding) while using them.
• Inform your doctor if you are using certain antibiotics, HIV medicines, etc., before starting your Mirtazapine regime.
• Cimetidine can increase the levels of Mirtazapine, which can cause side effects.
• Mirtazapine can interact with many other medicines. Inform your doctor of all current treatments and medication before taking Mirtazapine.

Interactions with food items

• Try to avoid grapefruit and its juice as it can increase the levels of this medicine in the body and cause side effects.
• Also, try to avoid too much coffee or caffeine-related products and drinks. It can interfere with the effects of this medicine. It can also increase serotonin levels in the body, leading to severe side effects.

Overdose

Missed a Dose