Mirtazapine Canon, 30 mg 30 pcs

A tetracycline antidepressant. Enhances central adrenergic and serotonergic transmission. It blocks serotonin 5-HT2- and 5-HT3-receptors, due to this the enhancement of serotonergic transmission is realized only through serotonin 5-HT1-receptors.

Both spatial enantiomers are involved in the antidepressant activity: S(+)-enantiomer blocks α2-adrenoceptors and serotonin 5-HT2-receptors. Moderately blocks histamine H1-receptors, has a sedative effect.

Little effect on α1-adrenoreceptors and cholinoreceptors; in therapeutic doses has no significant effect on the cardiovascular system.

In clinical conditions, anxiolytic and hypnotic effects are also seen, which is why mirtazapine is most effective for anxiety depressions of different genesis. Because of moderate sedative action during treatment it does not actualize suicidal thoughts.

Pharmacokinetics

Mirtazapine is rapidly absorbed from the gastrointestinal tract after oral administration. Bioavailability is 50%. Cmax in plasma is reached after 2 hours.

The Css in plasma is established after 3-4 days of continuous administration. Binding to plasma proteins is 85%.

It is actively metabolized in the liver by demethylation and oxidation followed by conjugation. Dimethyl-mirtazapine is as pharmacologically active as the parent substance.

Mirtazapine is excreted by the kidneys and through the intestine. The T1/2 is 20-40 hrs.

In renal and hepatic insufficiency, the clearance of mirtazapine may be decreased.

Indications

Depressive states (including anhedonia, psychomotor retardation, insomnia, early awakening, weight loss, loss of interest in life, suicidal thoughts and mood lability).

Active ingredient

Composition

mirtazapine45 mg

How to take, the dosage

When administered orally, the effective dose for adults is 15-45 mg/day preferably once daily before bedtime. The dose is gradually increased up to 30-45 mg/day.

The antidepressant effect develops gradually, usually after 2-3 weeks of treatment, but administration should be continued for another 4-6 months. If no therapeutic effect is noted within 6-8 weeks of treatment, treatment should be discontinued.

Withdrawal of mirtazapine should be done gradually.

Interaction

When used concomitantly, mirtazapine increases the sedative effect of benzodiazepine derivatives.

A case of hypertensive crisis has been described when used concomitantly with clonidine.

In concomitant use with levodopa a case of severe psychosis has been described; with sertraline a case of hypomania.

In concomitant use with ethanol it is possible to increase the CNS depressant effect of ethanol and ethanol-containing drugs.

Special Instructions

With caution, use in patients with epilepsy and organic brain lesions, hepatic and/or renal dysfunction, acute cardiovascular disease, arterial hypotension, urinary disorders due to benign prostatic hyperplasia, closed-angle glaucoma, diabetes mellitus.

In patients with schizophrenia, mirtazapine may cause increased delirium, hallucinations. When treating the depressive phase of manic-depressive psychosis, this condition may progress to the manic phase.

The sudden discontinuation of mirtazapine after long-term treatment may cause nausea, headache, and worsening of well-being.

Please note that if symptoms such as fever, sore throat, stomatitis occur during treatment, treatment should be stopped and a clinical blood test done.

Mirtazapine should be stopped if jaundice occurs.

Do not use concomitantly with MAO inhibitors and for 2 weeks after their withdrawal.

The development of drug dependence and withdrawal syndrome is possible.

Patients should refrain from drinking alcohol during treatment.

Mirtazapine is not used in children due to lack of data on the effectiveness and safety of its use in pediatric practice.

Impact on ability to drive and operate machinery

Perhaps with caution in patients whose activities require high concentration and quick psychomotor reactions.

Contraindications

Hepatic and renal failure, pregnancy, lactation, hypersensitivity to mirtazapine.

Side effects

CNS and peripheral nervous system disorders: somnolence, lethargy, emotional lability, mental changes, agitation, anxiety, apathy, hallucinations, depersonalization, hostility, mania, epileptic seizures, vertigo, vertigo, hyperesthesia, seizures, tremors, myoclonus, hyperkinesis, hypokinesia.

Hematopoietic organs: suppression of hematopoiesis – granulocytopenia, agranulocytosis, neutropenia, eosinophilia, aplastic anemia, thrombocytopenia.

Metabolic side: slight increase of appetite and weight gain; edema in single cases.

Cardiovascular system: rare – orthostatic hypotension.

Gastrointestinal system disorders: nausea, vomiting, constipation, increased appetite, weight gain, dry mouth, thirst, abdominal pain; in single cases – increased liver transaminase activity.

In the sexual system: decreased potency, dysmenorrhea.

Others: skin rashes, urticaria, flu-like syndrome, choking, edema syndrome, myalgia, back pain dysuria.

Similarities