Remeron (Mirtazapine)

Do's

• Remeron is typically taken orally, with or without food, as directed by a healthcare provider. The dosage is based on the individual's medical condition and response to treatment. 
• The typical starting dose is 15 mg taken once daily, usually in the evening. Your healthcare provider may adjust the dose every 1 to 2 weeks based on the treatment response, with the maximum recommended dose being 45 mg once daily.
• Take Remeron exactly as directed by your healthcare provider. The medication should be taken at the same time each day to help ensure its effectiveness. It may take 1 to 4 weeks to notice an improvement in symptoms. Do not increase the dose or take it more often than prescribed.
• Using the medication regularly is essential to obtain the most benefit from it. Even if you feel well, do not stop taking the medication without consulting your healthcare provider, as some conditions may worsen if the drug is suddenly discontinued. If discontinuation is necessary, the dose may need to be gradually decreased.
• If a dose is missed, it should be taken as soon as remembered. However, if it is close to the time of the next scheduled dose, only one dose should be taken. Taking two doses at once could result in dangerous side effects.
• In the event of an overdose, immediate medical attention should be sought. Overdose symptoms may include confusion, memory problems, drowsiness, and a fast heart rate.
• Keep your healthcare provider informed about your condition; inform them if there is no improvement or if your condition worsens.

Common Side Effects:

• Drowsiness
• Dizziness
• Increased appetite
• Weight gain

Serious Side Effects:

• Symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea
• Swelling of the hands/feet
• Shaking (tremor)
• Confusion
• Fast/irregular heartbeat
• Severe dizziness
• Fainting
• Eye pain/swelling/redness
• Widened pupils
• Vision changes (such as seeing rainbows around lights at night, blurred vision)
• Suicidal thoughts and behaviors, especially in pediatric and young adult patients taking antidepressants

Seek medical attention right away if any of the serious side effects mentioned above are experienced. 

This is not a complete list of side effects, and others may occur. Contact your healthcare provider for medical advice about side effects.

Remeron may cause drowsiness, dizziness, and increased appetite, which can impair judgment, thinking, and motor skills. Be cautious when performing activities requiring mental alertness, such as operating hazardous machinery or driving until you are reasonably certain that Remeron therapy does not adversely affect your ability to engage in such activities.

Avoid alcohol while taking Remeron, as it can exacerbate the sedative effects of the medication.

Patients and their caregivers should observe for signs of activation of mania/hypomania and report such symptoms to the healthcare provider.

Adverse reactions may occur upon discontinuation or dose reduction of Remeron. It is recommended to gradually reduce the dosage of Remeron rather than stopping it abruptly.

Prior to initiating treatment with Remeron or another antidepressant, patients should be screened for a personal or family history of bipolar disorder, mania, or hypomania.

At least 14 days must elapse between discontinuation of an MAOI antidepressant and initiation of Remeron. Additionally, at least 14 days must elapse after stopping Remeron before starting an MAOI antidepressant.

Remeron is not approved for use in pediatric patients.

Keep all appointments with your healthcare provider and the laboratory, and do not let anyone else take this medication. Maintain a written list of all prescription and nonprescription medicines you are taking and bring this list each time you visit a healthcare provider or are admitted to a hospital.

Consult your healthcare provider for personalized advice and guidance regarding the use of Remeron and its associated warnings and precautions.