Why is this medication prescribed?

Mirtazapine, an antidepressant or mood elevator, is used to treat depression.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Mirtazapine comes as a tablet and as a disintegrating tablet to take by mouth. It usually is taken once a day at bedtime. It may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take mirtazapine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

To take a mirtazapine disintegrating tablet, open the blister pack with dry hands and place the tablet on your tongue. The tablet will disintegrate on the tongue and can be swallowed with saliva. No water is needed to swallow disintegrating tablets. Once the tablet is removed from the blister pack, it cannot be stored. Do not split mirtazapine disintegrating tablets.

Continue to take mirtazapine even if you feel well. Do not stop taking mirtazapine without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

What special precautions should I follow?

Before taking mirtazapine,

• tell your doctor and pharmacist if you are allergic to mirtazapine or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially diazepam (Valium) and vitamins. Do not take mirtazapine if you are taking an MAO inhibitor [phenelzine (Nardil) or tranylcypromine (Parnate)]; these drugs need to be stopped 14 days before starting mirtazapine.
• tell your doctor if you have or have ever had a heart attack, low blood pressure, heart or liver disease, phenylketonuria, or high cholesterol.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking mirtazapine, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking mirtazapine.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
• remember that alcohol can add to the drowsiness caused by this drug.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Although side effects from mirtazapine are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• dizziness
• anxiousness
• confusion
• increased weight and appetite
• dry mouth
• constipation
• upset stomach
• vomiting

If you experience any of the following symptoms, call your doctor immediately:

• flu-like symptoms, fever, chills, sore throat, mouth sores, or other signs of infection
• chest pain
• fast heartbeat
• seizures

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to mirtazapine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.