Mirtazapine

Mirtazapine belongs to a group of antidepressants known as noradrenergic and specific serotonergic antidepressant (NaSSA).

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​What is this medication used for

Mirtazapine belongs to a group of antidepressants known as noradrenergic and specific serotonergic antidepressant (NaSSA).
 
Mirtazapine is used to treat symptoms of depression (low mood) such as sad feelings, feelings of hopelessness or worthlessness, poor energy or appetite.  ​
 
The medicine may also be used for other conditions, check with your doctor.
 

Dosage and How to Use​​​

Follow the directions on your medicine label and take the medicine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Mirtazapine can be taken with or without food. 

Mirtazapine orodispersible tablets (orally disintegrating)  should be handled with care as they break easily. Do NOT handle the tablets with wet hands as they may break up. Do NOT break, split or crush mirtazapine orodispersible tablets. 

To remove orodispersible tablets from the blister strip

  1. Separate one blister cell from the rest of the strip by gently tearing along the perforations around it.
     
  2. Carefully peel off the lidding foil, starting in the corner indicated by the black arrow, to expose the tablet fully.
     
  3. Place the tablet into your mouth immediately, where it will dissolve directly and be easily swallowed. 

 

This medicine must be taken regularly for a few weeks before your symptoms of low mood gradually improve.

Once these symptoms are under control, you should continue taking this medication regularly to prevent the return of your depressive or anxiety symptoms. Do check with your doctor on the appropriate length of treatment you need.

Do not stop taking it without talking to your doctor. Stopping this medication suddenly after taking for a long time may lead to mild discontinuation symptoms such as nausea, anxiety, insomnia, headache and dizziness.


Missed a Dose

Take the missed dose as soon as you remember it. However, if it is more than half way between the doses, skip the missed dose and take your medicine at the usual time. Do not take two or more doses at the same time to make up for a missed one.

 

​Side Effects, Precautions, Contraindication​

Before using this medicine

Tell your doctor if you have any drug allergies or have ever had heart, liver, or kidney disease; seizures (fits); diabetes; urinary problems; high cholesterol; low blood pressure; phenylketonuria; bipolar disorder; schizophrenia.

FOR WOMEN: Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.

 

Possible Side Effects

Like all medications, this medication may also cause some POSSIBLE side effects in some people. Everyone responds differently to medications; so not everyone experiences any or all of them.

COMMON (Generally affect up to 10% of patients)
 
Most of these side effects below will get better or go away completely with continued medication taking as your body gets used to
this medication. Contact your doctor or pharmacist should they become too bothersome to you.

~ Drowsiness
 
~ Dry mouth (suck ice chips or sugarless candy if necessary)
 
~ Increase in appetite, weight gain (exercise regularly and avoid excessive intake of high fat food)
 
~ Constipation (drink more fluids, regular exercise, take fiber-rich diet, or talk to your doctor about stool softener or laxative)
 
~ Dizziness (can be reduced by getting up slowly from a sitting or lying down position)
 
~ Tiredness


FOR URGENT ATTENTION
 
Check with your doctor as soon as possible if you have any of the following:

~ Allergic reaction: Skin rash or itching, difficulty breathing, swelling of the eyes, face, or lips
 
~ Swelling in hands, ankles or feet
 
~ Flu-like symptoms (fever, chills, sore throat); mouth sores / ulcers
 
~ Severe vomiting or diarrhea, loss of appetite, abdominal pain
 
~ Confusion, severe weakness, uncontrolled movements or twitching of muscles
 
~ Feelings of intense agitation or anxiety, restlessness or inability to sit still, or irritability
 
~ Unusual thoughts; talking, feeling, and acting with excitement that you cannot control
 
~ Seizures (fits)​



If you have any concerns about your medications or if you have other side effects that you think are caused by this medicine, please consult your doctor or pharmacist.

 

Precautions while taking this medicine:

  • Mirtazapine may make you drowsy or less alert. Do not drive or operate machinery if affected. 
  • Avoid drinking alcohol while taking this medicine. Drinking alcohol can worsen symptoms of depression and side effect of drowsiness.
  • When you take this medicine with some other medicines, it may affect how they work. Be sure that you tell all doctors, pharmacists, dentists and other health care providers who treat you about all medicines and natural remedies you are taking.​
  • Your mental condition may change in unexpected ways especially at the beginning (first few weeks) of treatment and during dose changes. Contact your doctor immediately if you or your child (the patient) experience new or worsening thoughts of harming or yourself, increase in symptoms such as anxiety, restlessness, violent behaviour, or other changes in mood and behaviour. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own
  • Mirtazapine orodispersible tablet contains aspartame as an excipient, thus let your healthcare provider know if you are phenylketouric.

 

​Handling and Stora​ge​

Store this medicine at room temperature, away from direct light, heat and moisture (not in the bathroom) and out of reach of children. 

Throw away any medication that is expired or no longer needed.

Do not remove the tablet from the blister until just prior to taking your tablet; once emoved, it cannot be stored.

Do not share the medicine with other people. 
Ask your doctor or pharmacist for more information or if you have any questions.​

​​​



​Institute of Mental Health

Pharmacy Department​​
10 Buangkok View
Singapore 539747

For medication enquiries: (during office hours)

IMH Clinic B/ Sayang Wellness: 63892077

IMH Clinic C (NAMS): 63893666

Community Wellness Clinic, Queenstown: 64715797

Community Wellness Clinic, Geylang: 67461724

Child Guidance Clinic (HPB): 64353807

Child Guidance Clinic (Sunrise Wing): 63892410 

Email: enquiry@imh.com.sg
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