Remeron

Generic Name: mirtazapine (mir TAH zah peen)

What is Remeron?

Remeron is a tetracyclic antidepressant. It affects chemicals in the brain that may become unbalanced and cause depression. It is thought to increase the activity of norepinephrine and serotonin which help elevate mood.

Remeron is used to treat major depressive disorder.

Remeron may also be used for purposes other than those listed in this medication guide.

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

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Do not use Remeron if you have used an MAO inhibitor within the past 14 days. Serious, life-threatening side effects can occur if you take Remeron before the MAO inhibitor has cleared from your body.

Before taking Remeron, tell your doctor if you have bipolar disorder, liver or kidney disease, seizures, heart disease, a history of heart attack or stroke, or a history of drug abuse or suicidal thoughts.

It may take up to several weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment. Avoid drinking alcohol. It can increase some of the side effects of Remeron. Remeron can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking Remeron?

You should not take this medication if you are allergic to mirtazapine.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Do not use Remeron if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Remeron before the MAO inhibitor has cleared from your body.

Before taking Remeron, tell your doctor if you are allergic to any drugs, or if you have:

bipolar disorder (manic depression);

seizures or epilepsy;

heart disease, including angina (chest pain);

a history of heart attack or stroke; or

a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may not be able to use Remeron, or you may need a dosage adjustment or special tests during treatment.

Remeron is in the FDA pregnancy category C. This means that it is not known whether Remeron will harm an unborn baby. Do not take Remeron without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Remeron passes into breast milk. Do not take Remeron without first talking to your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the side effects of this medication.

The orally disintegrating tablet may contain phenylalanine. Talk to your doctor before using this form of mirtazapine if you have phenylketonuria (PKU).

How should I take Remeron?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take the regular tablet form of mirtazapine with water.

To take mirtazapine orally disintegrating tablets (Remeron SolTab):

Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may break the tablet.

Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Swallow several times as the tablet dissolves. No water is needed.

Remeron is usually taken once a day at bedtime. Follow your doctor’s instructions.

It may take up to several weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment. Store Remeron at room temperature, away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include confusion, memory problems, drowsiness, and fast heart rate.

What should I avoid while taking Remeron?

Avoid drinking alcohol. It can increase some of the side effects of mirtazapine. Remeron can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Remeron side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

fever, chills, body aches, flu symptoms;

white patches or sores inside your mouth or on your lips; or

feeling like you might pass out.

Less serious side effects include:

drowsiness, dizziness, weakness;

nausea, stomach pain;

constipation;

increased appetite, weight gain;

dry mouth; or

thirst.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Remeron?

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Remeron. Tell your doctor if you need to use any of these other medicines while you are taking Remeron.

There may be other drugs that can interact with Remeron. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.