Medicines

Mirtanza Tablets: Uses, Dosage, Side Effects, Interactions

What is Mirtanza used for?

Mirtanza oral tablet is an Australian brand of mirtazapine, an atypical antidepressant used primarily for the treatment of a major depressive disorder. The drug has sedative, antiemetic, anxiolytic, and appetite stimulant effects, which explains its off-label use for insomnia, panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, generalized anxiety disorder, social anxiety disorder, headaches, and migraines.

How Mirtanza works

Mirtazapine is in a class of medications called antidepressants. It works by increasing certain types of activity in the brain to maintain mental balance. Mirtanza may be used as part of a combination therapy. This means you may need to take it with other medications.

How long does it take Mirtanza to kick in?

Mirtanza may work faster than other antidepressants, especially for insomnia and anxiety. Many people feel some improvement shortly after starting the medication, but it can take up to 6 weeks before you feel the full benefits.

How should I take Mirtanza?

Mirtanza comes as a 15 and 30mg tablet to take by mouth. It usually is taken once a day at bedtime. It may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take mirtazapine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

The typical starting dose is 15 mg by mouth once a day in the evening. The maximum dose is usually 45 mg once a day.

It may take several weeks or longer for you to feel the full benefit of Mirtanza. Continue to take mirtazapine even if you feel well. Do not stop taking Mirtanza without talking to your doctor. Your doctor probably will decrease your dose gradually.

What are the side effects of Mirtanza?

Mirtanza oral tablet may cause drowsiness. It may affect your ability to make decisions, think clearly, or react quickly. You shouldn’t drive, use machinery, or do other activities that require alertness until you know how this drug affects you.

You may feel restless and agitated (unable to sit or stand still) for the first few weeks while taking this drug.

More common side effects

The more common side effects of Mirtanza can include:

•        sleepiness

•        increased appetite

•        weight gain

•        dry mouth

•        constipation

•        dizziness

•        strange dreams

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

•        Suicidal thoughts or actions. Symptoms can include:

o       attempts to commit suicide

o       acting on dangerous impulses

o       acting aggressive or violent

o       thoughts about suicide or dying

o       new or worsened depression

o       new or worsened anxiety or panic attacks

o       feeling agitated, restless, angry, or irritable

o       trouble sleeping

o       an increase in activity or talking more than normal

o       other unusual changes in behavior or mood

•        Manic episodes. Symptoms can include:

o       greatly increased energy

o       severe trouble sleeping

o       racing thoughts

o       reckless behavior

o       unusually grand ideas

o       excessive happiness or irritability

o       talking more or faster than normal

•        Weakened immune system. Mirtanza may decrease your white blood cells. White blood cells help your body fight infections. This can make you more likely to get infections. Symptoms can include:

o       fever

o       chills

o       sore throat

o       mouth or nose sores

o       flu-like symptoms, such as body aches, fatigue, and vomiting

•        Serotonin syndrome. This condition can be life-threatening. Symptoms can include:

o       agitation

o       hallucinations (seeing or hearing something that isn’t there)

o       coma

o       confusion

o       trouble thinking

o       coordination problems

o       muscle twitching or stiff muscles

o       racing heartbeat

o       high or low blood pressure

o       sweating or fever

o       nausea, vomiting, or diarrhea

•        Eye problems. Symptoms can include:

o       eye pain

o       changes in vision

o       swelling or redness in or around your eye

•        Seizures

•        Low sodium (salt) levels in your blood. Seniors may be at a higher risk for this problem. Symptoms can include:

o       headache

o       feeling unsteady or weak

o       confusion, trouble concentrating or thinking, or memory problems

•        Sleepiness

•        Severe skin reactions. Symptoms can include:

o       severe rash with skin swelling (including on the palms of your hands and soles of your feet)

o       painful reddening of your skin or blisters or ulcers (open sores) on your body or in your mouth

•        Severe allergic reactions. Symptoms can include:

o       trouble breathing

o       swelling of your face, tongue, eyes, or mouth

o       rash, itchy welts (hives), or blisters, alone or with fever or joint pain

•        Increased appetite or weight

•        High cholesterol and triglyceride levels

•        Rhabdomyolysis (a serious muscle problem). Symptoms can include:

o       muscle aches and pains

o       kidney problems

What medications can interact with Mirtanza?

Using Mirtanza with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

•        Bepridil

•        Bromopride

•        Cisapride

•        Dronedarone

•        Fluconazole

•        Furazolidone

•        Iproniazid

•        Isocarboxazid

•        Linezolid

•        Mesoridazine

•        Methylene Blue

•        Moclobemide

•        Nialamide

•        Phenelzine

•        Pimozide

•        Piperaquine

•        Posaconazole

•        Procarbazine

•        Rasagiline

•        Safinamide

•        Selegiline

•        Sparfloxacin

•        Terfenadine

•        Thioridazine

•        Tranylcypromine

•        Ziprasidone

Using Mirtanza with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

•        Alfentanil

•        Alfuzosin

•        Almotriptan

•        Alprazolam

•        Amineptine

•        Amiodarone

•        Amisulpride

•        Amitriptyline

•        Amitriptylinoxide

•        Amoxapine

•        Amphetamine

•        Anagrelide

•        Anileridine

•        Apalutamide

•        Apomorphine

•        Aripiprazole

•        Aripiprazole Lauroxil

•        Arsenic Trioxide

•        Asenapine

•        Astemizole

•        Atazanavir

•        Azithromycin

•        Bedaquiline

•        Bentazepam

•        Benzhydrocodone

•        Benzphetamine

•        Boceprevir

•        Bromazepam

•        Brompheniramine

•        Buprenorphine

•        Buserelin

•        Buspirone

•        Butorphanol

•        Carbamazepine

•        Ceritinib

•        Chlordiazepoxide

•        Chloroquine

•        Chlorpheniramine

•        Chlorpromazine

•        Ciprofloxacin

•        Citalopram

•        Clarithromycin

•        Clobazam

•        Clofazimine

•        Clomipramine

•        Clonazepam

•        Clonidine

•        Clorazepate

•        Cloxazolam

•        Clozapine

•        Cobicistat

•        Cocaine

•        Codeine

•        Conivaptan

•        Crizotinib

•        Cyclobenzaprine

•        Dabrafenib

•        Dasatinib

•        Degarelix

•        Delamanid

•        Delorazepam

•        Desipramine

•        Deslorelin

•        Desvenlafaxine

•        Deutetrabenazine

•        Dextroamphetamine

•        Dextromethorphan

•        Diazepam

•        Dibenzepin

•        Difenoxin

•        Dihydrocodeine

•        Diphenoxylate

•        Disopyramide

•        Dofetilide

•        Dolasetron

•        Domperidone

•        Donepezil

•        Doxepin

•        Droperidol

•        Duloxetine

•        Ebastine

•        Efavirenz

•        Eletriptan

•        Encorafenib

•        Entrectinib

•        Enzalutamide

•        Eribulin

•        Erythromycin

•        Escitalopram

•        Estazolam

•        Ethylmorphine

•        Famotidine

•        Felbamate

•        Fenfluramine

•        Fentanyl

•        Fingolimod

•        Flecainide

•        Flunitrazepam

•        Fluoxetine

•        Flurazepam

•        Fluvoxamine

•        Formoterol

•        Foscarnet

•        Fosphenytoin

•        Frovatriptan

•        Galantamine

•        Gatifloxacin

•        Gemifloxacin

•        Glasdegib

•        Gonadorelin

•        Goserelin

•        Granisetron

•        Halazepam

•        Halofantrine

•        Haloperidol

•        Histrelin

•        Hydrocodone

•        Hydromorphone

•        Hydroquinidine

•        Hydroxychloroquine

•        Hydroxytryptophan

•        Hydroxyzine

•        Ibutilide

•        Idelalisib

•        Iloperidone

•        Imipramine

•        Indinavir

•        Inotuzumab Ozogamicin

•        Itraconazole

•        Ivabradine

•        Ivosidenib

•        Ketazolam

•        Ketobemidone

•        Ketoconazole

•        Lapatinib

•        Lasmiditan

•        Lenvatinib

•        Leuprolide

•        Levofloxacin

•        Levomilnacipran

•        Levorphanol

•        Lisdexamfetamine

•        Lithium

•        Lofepramine

•        Lofexidine

•        Lopinavir

•        Loprazolam

•        Lorazepam

•        Lorcaserin

•        Lormetazepam

•        Lumacaftor

•        Lumefantrine

•        Macimorelin

•        Medazepam

•        Mefloquine

•        Melitracen

•        Meperidine

•        Metaclazepam

•        Metaxalone

•        Methadone

•        Methamphetamine

•        Methotrimeprazine

•        Metronidazole

•        Midazolam

•        Mifepristone

•        Milnacipran

•        Mitotane

•        Mizolastine

•        Moricizine

•        Morphine

•        Morphine Sulfate Liposome

•        Moxifloxacin

•        Nafarelin

•        Nalbuphine

•        Naratriptan

•        Nefazodone

•        Nelfinavir

•        Nicomorphine

•        Nilotinib

•        Nitrazepam

•        Nordazepam

•        Norfloxacin

•        Nortriptyline

•        Octreotide

•        Ofloxacin

•        Olanzapine

•        Ondansetron

•        Opipramol

•        Opium

•        Opium Alkaloids

•        Osilodrostat

•        Osimertinib

•        Oxaliplatin

•        Oxazepam

•        Oxycodone

•        Oxymorphone

•        Paliperidone

•        Palonosetron

•        Panobinostat

•        Papaveretum

•        Papaverine

•        Paregoric

•        Paroxetine

•        Pasireotide

•        Pazopanib

•        Pentamidine

•        Pentazocine

•        Perphenazine

•        Phenytoin

•        Pimavanserin

•        Pinazepam

•        Pipamperone

•        Piritramide

•        Pitolisant

•        Prazepam

•        Probucol

•        Procainamide

•        Prochlorperazine

•        Promethazine

•        Propafenone

•        Protriptyline

•        Quazepam

•        Quetiapine

•        Quinidine

•        Quinine

•        Ranolazine

•        Remifentanil

•        Remimazolam

•        Ribociclib

•        Rifampin

•        Risperidone

•        Ritonavir

•        Rizatriptan

•        Saquinavir

•        Selpercatinib

•        Sertindole

•        Sertraline

•        Sevoflurane

•        Sibutramine

•        Siponimod

•        Sodium Phosphate

•        Sodium Phosphate, Dibasic

•        Sodium Phosphate, Monobasic

•        Solifenacin

•        Sorafenib

•        Sotalol

•        St John’s Wort

•        Sufentanil

•        Sulpiride

•        Sultopride

•        Sumatriptan

•        Sunitinib

•        Tacrolimus

•        Tamoxifen

•        Tapentadol

•        Telaprevir

•        Telavancin

•        Telithromycin

•        Temazepam

•        Tetrazepam

•        Tianeptine

•        Tilidine

•        Tolterodine

•        Toremifene

•        Tramadol

•        Trazodone

•        Triazolam

•        Triclabendazole

•        Trimipramine

•        Triptorelin

•        Tryptophan

•        Vandetanib

•        Vardenafil

•        Vemurafenib

•        Venlafaxine

•        Vilanterol

•        Vilazodone

•        Vinflunine

•        Voriconazole

•        Vorinostat

•        Vortioxetine

•        Warfarin

•        Zolmitriptan

•        Zotepine

•        Zuclopenthixol

Using Mirtanza with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

•        Cimetidine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

•        Tobacco

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

•        Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

•        Angina (severe chest pain), history of or

•        Blood vessel disease or circulation problems or

•        Dehydration or

•        Heart attack, history of or

•        Heart disease or

•        Hypotension (low blood pressure) or

•        Hypovolemia (low blood volume) or

•        Stroke, history of—May cause side effects to become worse.

•        Bipolar disorder (mood disorder with mania and depression) or

•        Glaucoma, angle-closure or

•        Heart rhythm problems (eg, QT prolongation) or

•        Hypercholesterolemia (high cholesterol in the blood) or

•        Hyponatremia (low sodium in the blood) or

•        Mania or hypomania, history of or

•        Seizures, history of—Use with caution. May make these conditions worse.

•        Kidney disease, moderate or severe or

•        Liver disease—Use with caution. The effects may be increased because of the slower removal of the medicine from the body.

•        Phenylketonuria (a metabolic disorder)—The orally disintegrating tablet contains aspartame, which can make this condition worse.

Frequently asked questions about Mirtanza

Is Mirtanza a sleeping pill?

Sleepiness is a common side effect of Mirtanza, so you might find that it helps you sleep better (especially at lower doses). However, the active ingredient in Mirtanza is not a sleeping pill and is not FDA-approved to treat insomnia or other sleeping conditions.

Does Mirtanza help with anxiety?

While Mirtanza is only approved for depression, in some cases it may be helpful with anxiety and panic attacks.

Is Mirtanza like Xanax?

No. You might experience some of the same side effects while taking Xanax or Mirtanza, but the two medications belong to different medication classes. Mirtanza is an antidepressant, while Xanax is a benzodiazepine. They work on different chemicals in your brain to change your mood.

Does everyone gain weight on Mirtanza?

No. While weight gain is more common with Mirtanza than other antidepressants, this side effect was only seen in 12% of people who took it during research studies. For most of them, the weight gain was minor (only a few pounds).

Is Mirtanza safe to take while pregnant?

It’s unknown if Mirtanza will harm your unborn baby. Let your provider know if you’re pregnant or planning on becoming pregnant before starting this medication. There is a National Pregnancy Registry for Psychiatric Medications to monitor the safety of certain medications during pregnancy. If you are currently pregnant and taking Mirtanza, it is encouraged that you enroll in the registry.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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