Mirtazapine Pharmacology


About Mirtazapine
Tetracyclic Antidepressant, piperazino-azepine group, Antidepressant.
Mechanism of Action of Mirtazapine
Mirtazapine antagonizes alpha 2 adrenergic receptors, 5HT2 and 5HT3 receptors. This will enhance noradrenergic and serotonergic activities. Mirtazapine also has potent antihistamine activity. The increase in concentration of neurotransmitters produces antidepressant activity.

Pharmacokinets of Mirtazapine
Absorption: It is well absorbed after oral administration but the bioavailability is about 50 % only. Distribution: Mirtazapine is distributed in the body in protein bound form. Metabolism: It is extensively metabolised in the liver. Excretion: It is excreted mainly through urine and also through faeces.

Onset of Action for Mirtazapine
Duration of Action for Mirtazapine
Half Life of Mirtazapine
20 - 40 hours
Side Effects of Mirtazapine
2.Increased appetite
4.Dry mouth
7.Abnormal dreams
8.Abnormal drinking
12.Urinary frequency
13.Weight gain
15.Flu like syndrome
17.Back pain
Contra-indications of Mirtazapine
Hypersensitivity to Mirtazapine
Special Precautions while taking Mirtazapine
1. Renal impairment
2. Hepatic impairment
3. Cardiovascular diseases
4. Epilepsy
5. Agranulocytosis
6. Alcoholics
7. Patient on MAOI therapy (Discontinue the MAO inhibitor at least 2 weeks before Mirtazapine is started)
8. Patient at high risk of suicide
9. Slowly withdraw the drug with caution
10. Patient should be cautioned against driving vehicle, operating machine and activities requiring mental alertness or judgment
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
NEONATES: contraindicated
Indications for Mirtazapine
Interactions for Mirtazapine
Drugs that are metabolised by and/or inhibit cytochrome P450 enzymes: Mirtazapine is not a potent inhibitor of various cytochrome P450 enzymes.
Alcohol: Impairment of cognitive and motorskills produced by mirtazapine has been shown to be additive to those produced by alcohol. Patients are advised to avoid alcohol while taking mirtazapine.
Diazepam: Impairment of cognitive and motor skills produced by mirtazapine has been shown to be additive to those produced by diazepam. Patients are advised to avoid diazepam and other similar drugs while taking mirtazapine.
Typical Dosage for Mirtazapine
Initial dose: 15 mg / day taken at night. Dose can be gradually increases up to 45 mg / day.
Maintenance dose: 15 - 45 mg / day
Maximum daily dose 60 mg / day

Schedule of Mirtazapine
Storage Requirements for Mirtazapine
Store at 15 - 30 degree C in a tightly closed container. Protect from direct light and heat. Keep out of the reach of children.
Effects of Missed Dosage of Mirtazapine
Take the missed dose as soon as remembered and if it is the time to take the next dose then skip the missed dose.
Effects of Overdose of Mirtazapine
Give supportive measures and symptomatic treatment. Drug can be removed from the body by inducing emesis and gastric lavage. Absorption of the drug can be reduced by Charcoal administration.

Home Delivery for Mirtazapine in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including mirtazapine.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for mirtazapine and other medicines and health products. Home delivery services for mirtazapine may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take mirtazapine only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for mirtazapine before they complete the sale. You can get this information while placing the order for mirtazapine with the pharmacy.

Mirtazapine is a generic medicine name and there are several brands available for it. Some of the brands for mirtazapine might be better known than mirtazapine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have mirtazapine in stock, you can ask for one of the branded alternatives for mirtazapine.