Remeron, Zisprin

Before taking this medicine

Do not take mirtazapine if you are taking a monoamine oxidase inhibitor (MAOI), including linezolid or intravenous methylene blue, or have stopped an MAOI within the past 14 days. This combination increases the risk of serotonin syndrome. Do not take it if you are allergic to mirtazapine or any ingredient in the tablets. Severe skin reactions have been reported. Extra caution is needed in older adults and people with kidney or liver impairment, a seizure disorder, untreated narrow drainage angles in the eyes, or risk factors for QT prolongation (a heart rhythm problem). Screening for bipolar disorder is needed before treatment because mirtazapine may trigger mania or hypomania. Serotonin syndrome can occur with mirtazapine alone, and the risk increases with other medicines that affect serotonin, including SSRIs, SNRIs and triptans. Other concerns include low white blood cell counts, low blood sodium, increased appetite and weight gain, raised cholesterol or triglycerides, and increased liver enzymes. Contact your prescriber if you develop a sore throat, fever, mouth inflammation or other signs of infection. Treatment must be stopped and closely monitored if these occur with a low white blood cell count. Mirtazapine can cause sleepiness and impair judgment, thinking or movement. Use caution when driving or operating machinery. Treatment must be stopped if serotonin syndrome occurs or a severe reaction called DRESS is suspected.