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Mirtazapine Tablets, USP


Suicidality and Antidepressant Drugs


DESCRIPTION


CLINICAL PHARMACOLOGY


Pharmacodynamics


Pharmacokinetics


Special Populations


Geriatric


Pediatrics


Gender


Race


Renal Insufficiency


Hepatic Insufficiency


Clinical Trials Showing Effectiveness


INDICATIONS AND USAGE


CONTRAINDICATIONS


WARNINGS


Clinical Worsening and Suicide Risk

Table 1
   Age Range       Drug-Placebo Difference in Number of    Cases of Suicidality per 1000 PatientsTreated
  Increases Compared to Placebo
<1814 additional cases
18-245 additional cases
  Decreases Compared to Placebo
25-641 fewer case
>656 fewer cases

Screening Patients for Bipolar Disorder


Agranulocytosis


MAO Inhibitors


PRECAUTIONS


General


Somnolence


Dizziness


Increased Appetite/Weight Gain


Cholesterol/Triglycerides


Transaminase Elevations


Activation of Mania/Hypomania


Seizure


Use in Patients with Concomitant Illness


Information for Patients


Clinical Worsening and Suicide Risk


Agranulocytosis


Interference with Cognitive and Motor Performance


Completing Course of Therapy


Concomitant Medication


Alcohol


Pregnancy


Nursing


Laboratory Tests


Drug Interactions


Drugs Affecting Hepatic Metabolism


Drugs that are Metabolized by and/or Inhibit Cytochrome P450 Enzymes


Alcohol


Diazepam


Carcinogenesis, Mutagenesis, Impairment of Fertility


Carcinogenesis


Mutagenesis


Impairment of Fertility


Pregnancy


Teratogenic effects


Nursing Mothers


Pediatric Use


Geriatric Use


ADVERSE REACTIONS


Associated with Discontinuation of Treatment

Common Adverse Events Associated with Discontinuation of Treatment in 6-Week US Mirtazapine Trials
Adverse Event   Percentage of Patients Discontinuing   with Adverse Event
Mirtazapine(n=453)Placebo(n=361)
   Somnolence   10.4%2.2%
   Nausea1.5%0%

Commonly Observed Adverse Events in US Controlled Clinical Trials

Common Treatment–Emergent Adverse Events Associated with the Use of Mirtazapine in 6-Week US Trials
Adverse Event   Percentage of Patients Reporting   Adverse Event
Mirtazapine(n=453)Placebo(n=361)
   Somnolence54%18%
   Increased Appetite   17%2%
   Weight Gain12%2%
   Dizziness7%3%

Adverse Events Occurring at an Incidence of 1% or More Among Mirtazapine-Treated Patients

Body System AdverseClinical ExperienceMirtazapine(n=453)Placebo(n=361)
 Body as a Whole
   Asthenia8%5%
   Flu Syndrome5%3%
   Back Pain2%1%
 Digestive System
   Dry Mouth25%15%
   Increased Appetite17%2%
   Constipation13%7%
 Metabolic and Nutritional Disorders
   Weight Gain12%2%
   Peripheral Edema2%1%
   Edema1%0%
 Musculoskeletal System
   Myalgia2%1%
 Nervous System
   Somnolence54%18%
   Dizziness7%3%
   Abnormal Dreams4%1%
   Thinking Abnormal 3%1%
   Tremor2%1%
   Confusion2%0%
 Respiratory System
   Dyspnea1%0%
 Urogenital System
   Urinary Frequency2%1%

ECG Changes


Other Adverse Events Observed During the Premarketing Evaluation of Mirtazapine


Other Adverse Events Observed During Postmarketing Evaluation of Mirtazapine


DRUG ABUSE AND DEPENDENCE


Controlled Substance Class


Physical and Psychological Dependence


OVERDOSAGE


Human Experience


Overdose Management


DOSAGE AND ADMINISTRATION


Initial Treatment


Elderly and Patients with Renal or Hepatic Impairment


Maintenance/Extended Treatment


Switching Patients To or From a Monoamine Oxidase Inhibitor


HOW SUPPLIED

They are supplied by State of Florida DOH Central Pharmacy as follows:

This Product was Repackaged By:

State of Florida DOH Central Pharmacy 104-2 Hamilton Park Drive Tallahassee, FL 32304 United States

53808-0482-115 mg30 Tablets in a Blister PackYELLOW60505-0247
53808-0483-130 mg30 Tablets in a Blister PackPINK60505-0248
53808-0484-145 mg30 Tablets in a Blister PackWHITE60505-0249

Medication Guide

  • all risks and benefits of treatment with antidepressant medicines
  • all treatment choices for depression or other serious mental illness

15mg Label


30mg Label


45mg Label