What is Mirtazapine: Uses, Warnings & Interactions

How to take Mirtazapine

• Take your medicine as directed. The dose may need to be changed several times to find what works best for you. 

• Take mirtazapine tablets only once per day.

• The preferred time to take doses is before bedtime because mirtazapine can make people sleepy. 

• Mirtazapine can be taken with or without food.

• You may need to take this medicine for several weeks before you begin to feel better.

• Please read the Medication Guide that comes with this medicine. If it’s missing, a pharmacist can supply a copy.

• How to take mirtazapine tablets

  • Swallow the tablet whole with a drink of water.

  • Store mirtazapine tablets at room temperature away from light and moisture.

• How to take mirtazapine orally disintegrating tablets

  • Make sure your hands are dry before you handle the disintegrating tablet. 

  • Peel back the foil from the blister pack, then gently remove the tablet. 

  • Do not push the tablet through the foil. 

  • You must immediately use a tablet if you remove it from the blister pack.

  • Place the tablet whole on your tongue. 

  • Allow it to completely melt. Do not crush, break, or chew it.

  • Once it has melted, it can be swallowed with saliva. There is no need to drink water.

  • Store mirtazapine orally disintegrating tablets at room temperature, protected from light and moisture.

What to do if you miss a dose of Mirtazapine

• Take one dose of mirtazapine each day.

• If a dose is missed, take the dose as soon as it’s remembered. If it’s the next day, skip the missed dose. Instead, take the next dose at the time it’s normally taken.

• Do not take an extra dose to make up for a missed dose.

Mirtazapine contraindications

• This medicine is not right for everyone.

• Do not use it if you have had an allergic reaction to mirtazapine.

Mirtazapine warnings

• Tell any doctor or other healthcare provider who treats you that you are using this medicine.

• Your doctor will do lab tests regularly to check on the effects of this medicine. Keep all appointments.

• For some children, teenagers, and young adults, this medicine increases the risk of suicidal thoughts and behaviors. It may worsen depression or emotional problems. Talk with your doctor right away if you notice any thoughts or behavior changes that concern you. 

• Tell your doctor if you or anyone in your family has a history of bipolar disorder, mania, hypomania, other mental illnesses, or suicide attempts.

• Tell your doctor if you are pregnant or breastfeeding.

• Tell your doctor if you have:

  • Liver disease

  • Kidney disease

  • A history of heart problems or stroke

  • An abnormal heart rhythm called QT prolongation

  • Seizures

  • Glaucoma

  • Low white blood cell counts

  • High cholesterol

  • Low sodium

  • Low blood pressure

  • Phenylketonuria

• This medicine may cause the following problems: 

  • Serotonin syndrome

  • Decreased white blood cells, which can affect your body's ability to fight an infection

  • Low sodium levels in the blood 

  • Heart rhythm abnormalities

  • Angle-closure glaucoma

  • Increased cholesterol or fats in the blood

  • Low sodium

  • Manic episodes

• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.

• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Mirtazapine interactions

• To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements you use before taking amitriptyline.

• Tell other healthcare providers you are using this medicine before they prescribe new medications.

• Do not use this medicine and an MAO inhibitor (MAOI) within 14 days of each other.

• Some medicines and foods can affect how mirtazapine works or increase the risk or severity of side effects. Tell your doctor if you are taking:

  • Other antidepressants

  • Any other drug used to treat mental illness

  • Migraine drugs called triptans

  • Benzodiazepines, a type of sedative that treats anxiety and seizures

  • Amphetamines

  • Heart rhythm drugs

  • Macrolide antibiotics such as azithromycin

  • The anticonvulsants phenytoin or carbamazepine

  • The narcotic painkillers fentanyl or tramadol

  • The tuberculosis treatment rifampin

  • The blood thinner warfarin

  • Lithium

  • Cimetidine, an over-the-counter heartburn drug or prescription ulcer drug

  • The supplements tryptophan or St. John’s wort

• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

• Avoid drinking alcohol when using mirtazapine.

Find more detailed information about mirtazapine interactions to avoid here.