Mirtazapine

When ATH:
N06AX11

Characteristic.

Crystalline powder from white to cream color, slightly soluble in water.

Pharmacological action.
Antidepressant.

Application.

Depressive states.

Contraindications.

Hypersensitivity.

Restrictions apply.

Renal and hepatic impairment, infectious, Cardiovascular and cerebrovascular diseases, pregnancy, lactation, childhood (safety and effectiveness in children have not been established), advanced age.

Pregnancy and breast-feeding.

When pregnancy is possible only in case of emergency (adequate and well-controlled studies in pregnant women have not performed). At the time of treatment should stop breastfeeding (no data on the penetration of breast milk).

Side effects.

According to the placebo-controlled trials with treatment mirtazapine following side effects were observed in more than 1% cases and more, than placebo (in parentheses % occurrence placebo).

From the nervous system and sensory organs: drowsiness 54%(18%), asthenia 8%(5%), dizziness 7%(3%), unusual dreams 4%(1%), violation of the thinking process 3%(1%), tremor 2%(1%), confusion 2%(0%).

From the digestive tract: dry mouth 25%(15%), increased appetite 17%(2%), constipation 13%(7%).

Other: weight gain 12%(2%), flu-like symptoms 5%(3%), backache 2%(1%), myalgia 2%(1%), increased urination 2%(1%), peripheral edema 2%(1%), dyspnoea 1%(0%).

Adverse effects, noted in these clinical trials, at least in 1% patients, poluchavshih mirtazapine, and less common, than placebo: headache, infection, chest pain, heartbeat, tachycardia, orthostatic hypotension, nausea, dyspepsia, diarrhea, flatulence, decreased libido, hypertension, pharyngitis, rhinitis, Sweating, amblyopia, tynnyt, dysgeusia.

Cooperation.

Inducers or inhibitors of metabolizing enzymes can alter the concentration of mirtazapine in the blood. Alcohol and Diazepam additive impair cognitive function and coordination.

Overdose.

Symptoms: slackness, drowsiness, disorientation, tachycardia, amnesia.

Treatment: gastric lavage, Activated carbon, oxygenation and ventilation.

Dosing and Administration.

Inside, before bedtime, at a dose of 15-45 mg/day depending on the extent of the observed therapeutic and side effects. Dose adjustment is possible after 1-2 weeks of observation. The total duration of treatment — to 6 Months.

Precautions.

Be wary appoint patients with deficiency of the liver and kidneys, Related systems and psychoneurotic diseases in history.

Abolition of the treatment carried out, gradually reducing the dose and / or increasing the spacing of the reception. It should not be used simultaneously with MAO inhibitors and within 2 Weeks after their withdrawal. If you have symptoms of infectious diseases or change the blood picture treatment is interrupted.

Cooperation

Active substance	Description of interaction
Alprazolam	FMR: synergism. Do effect. Against the background of mirtazapine may deteriorate coordination.
Buprenorphine	FMR. Against the background of mirtazapine may deteriorate coordination.
Haloperidol	FMR. Against the background of mirtazapine may deteriorate coordination.
Gidroksizin	FMR. Against the background of mirtazapine may deteriorate coordination.
Diazepam	FMR: synergism. Strengthens (mutually) CNS depression. Against the background of mirtazapine worse cognitive function and coordination.
Zolpidem	FMR. Against the background of mirtazapine may deteriorate coordination.
Lorazepam	FMR: synergism. Strengthens (mutually) CNS depression. Against the background of mirtazapine may deteriorate coordination.
Promethazine	FMR. Against the background of mirtazapine may impair coordination.
Propofol	FMR. Against the background of mirtazapine may deteriorate (postanesthesia period) coordination.
Risperidone	FMR. Against the background of mirtazapine may deteriorate coordination.
Selegiline	FMR. Against the background of mirtazapine develop severe, sometimes fatal reactions, incl. hyperthermia, autonomic disorders, seizures, excitement and coma; simultaneous and / or sequential use is contraindicated.
Xlordiazepoksid	FMR. Against the background of mirtazapine may deteriorate coordination.
Ethanol	FMR: synergism. Strengthens (mutually) CNS depression, impairs cognitive function and coordination.