Precautions While on this Medicine
While you are taking mirtazapine you may need to be monitored for worsening symptoms
of depression and/or suicidal thoughts at the start of therapy or when doses are changed.
This concern about the increased risk of suicidal thoughts or behaviors may be greater if
you are 18 years of age or younger and are taking mirtazapine. In patients younger
than 18 years, the period of risk may extend beyond start of therapy or when doses are
Your doctor may want you to monitor for the following symptoms:
- anxiety, panic attacks
- difficulty sleeping
- severe restlessness
- mania (mental and/ or physical hyperactivity)
These symptoms may be associated with the development of worsening symptoms of depression
and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any
new or worsening mental health symptoms during treatment with mirtazapine. Do not stop
Use caution when driving, operating machinery, or performing other hazardous
activities. Mirtazapine may cause drowsiness and dizziness. If you experience
drowsiness or dizziness, avoid these activities.
Dizziness is likely to occur when you rise from a sitting or lying position.
Rise slowly to prevent dizziness and a possible fall. Avoid the use
of alcohol while taking mirtazapine. Alcohol may increase drowsiness and
Do not take mirtazapine if you are currently taking, or have taken within the last
14 days, a monoamine oxidase inhibitor such as:
- isocarboxazid (Marplan®)
- phenelzine (Nardil®)
- tranylcypromine (Parnate®)
Before taking mirtazapine, tell your doctor if you have:
- liver disease
- kidney disease
- a manic-depressive (bipolar) disorder
- blood problems
- high or low blood pressure or heart disease
- had a heart attack in the last 6 weeks
- epilepsy or seizures
You may not be able to take mirtazapine, or you may require a dosage adjustment or special
monitoring during treatment if you have any of the conditions listed above.
The rapidly-disintegrating formulation of mirtazapine tablets (Remeron SolTab)
contains phenylalanine.People with the disease phenylketonuria (PKU) need to monitor
their intake of this additive.
It is not known whether mirtazapine will harm an unborn baby. Do not take mirtazapine
without first talking to your doctor if you are pregnant or could become pregnant during
It is not known whether mirtazapine passes into breast milk.
Do not take mirtazapine
without first talking to your doctor if you are breast-feeding a baby.
If you are over 60 years of age, you may be more likely to experience side effects
such as drowsiness, dizziness, unsteadiness, feeling uncoordinated, and low blood
pressure. You may require a lower dose of this medication.