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NOTENSE

MIRTAZAPINE · by QINTAR PHARMA

ANTIDEPRESSANTS Presynaptic alpha-2-adrenoreceptor antagonist QINTAR PHARMA

Composition

Tab 15 mg/30 mg/45 mg: Mirtazapine 15 mg/30 mg/45 mg.

Indications & Dosage

Major depression: Adult: Initially 15-30 mg daily for 2-4 weeks, dose to be taken at bedtime, then adjusted according to response to up to 45 mg once daily, alternatively up to 45 mg daily in 2 divided doses.

Precautions

Hepatic or renal impairment, cardiac disorders, diabetes mellitus, elderly, history of bipolar depression, history of seizures, history of urinary retention, hypotension, psychoses, susceptibility to angle-closure glaucoma or increased intra-ocular pressure, organic brain syndrome, diabetes, angina, recent MI, prostatic hypertrophy. Monitor patients for suicidal ideation. Discontinue if jaundice occurs. Dose increases may be detrimental in patients who develop akathisia. Withdraw gradually.

Interactions

MAOIs, SSR1s, SNRIs, tryptophan, triptans, tramadol, linezolid, lithium, St. Johns Wort, and other serotonergic agents. CNS depressants, alcohol, protease inhibitors, erythromycin, nefazodone, cimetidine, warfarin, Carbamazepine, phenytoin and other CYP3A4 inducers, Ketoconazole, other azole antifungals and other potent CYP3A4 inhibitors

Pregnancy

Contraindicated

Lactation

Contraindicated

Side Effects

Agitation, anxiety, arthralgia, blood disorders, confusion, convulsions, dizziness, drowsiness, dry mouth, fatigue, headache, increased appetite, insomnia, myalgia, oedema, postural hypotension, tremor, weight changes, hallucinations, mania, movement disorders, syncope, dysarthria, hypersalivation, hyponatraemia, inappropriate secretion of antidiuretic hormone, sedation during initial treatment. Rare: Aggression, myoclonus, pancreatitis, angle-closure glaucoma, Stevens-Johnson syndrome, suicidal behavior, toxic epidermal necrolysis