Remeron - Comprehensive Usage Guide: instructions, indications, composition, side effects

• Active Ingredient: Mirtazapine
• Excipients: May include lactose monohydrate, cellulose microcrystalline, colloidal silicon dioxide, magnesium stearate, and other inactive ingredients depending on the formulation.

• Tablets: Available in various strengths, including 15 mg, 30 mg, and 45 mg tablets.
• Orally Disintegrating Tablets: Available in 15 mg, 30 mg, and 45 mg strengths.

Remeron belongs to the pharmacological group of antidepressants, specifically noradrenergic and specific serotonergic antidepressants (NaSSAs) (ATC code: N06AX11).

• Pharmacodynamics: Mirtazapine enhances noradrenergic and serotonergic neurotransmission by antagonizing central presynaptic alpha2-adrenergic autoreceptors and heteroreceptors. This mechanism increases the release of norepinephrine and serotonin in the brain, contributing to its antidepressant effects.
• Pharmacokinetics: Mirtazapine is well-absorbed after oral administration, with peak plasma concentrations achieved within 1.5 to 2 hours. It undergoes extensive hepatic metabolism via the cytochrome P450 system and is primarily eliminated via renal and fecal routes.

Remeron is indicated for the treatment of:

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)
• Insomnia (off-label use)

Remeron is contraindicated in individuals with a known allergy or hypersensitivity to mirtazapine or any other component of the formulation.
It should not be used concomitantly with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to the risk of serotonin syndrome.

Mirtazapine may interact with other medications, including MAOIs, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and CNS depressants. Caution is advised when combining Remeron with other central nervous system depressants or medications that affect hepatic metabolism.

Remeron tablets should be taken orally once daily, preferably at bedtime, with or without food, as directed by a healthcare provider.
The orally disintegrating tablets should be placed on the tongue and allowed to dissolve, with or without water.

The initial dosage of Remeron varies depending on the indication, patient age, and severity of symptoms. Healthcare providers may start with a low dose and titrate gradually to achieve optimal therapeutic effects while minimizing side effects.
Maintenance therapy typically involves long-term treatment with the lowest effective dose.

In cases of Remeron overdose, supportive measures should be initiated as needed. Symptoms of overdose may include drowsiness, confusion, tachycardia, and hypotension. Gastric lavage and activated charcoal may be considered to reduce absorption.

Common side effects of Remeron may include drowsiness, increased appetite, weight gain, dry mouth, and constipation. Serious adverse effects such as serotonin syndrome, agranulocytosis, and QT prolongation are rare but require immediate medical attention if they occur.

Store Remeron tablets at room temperature (15-30°C) in a dry place, protected from light and moisture.
Orally disintegrating tablets should be stored according to the manufacturer’s instructions, typically at controlled room temperature.