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APO-Mirtazapine 30mg
APO-Mirtazapine general information
What is APO-Mirtazapine used for?
APO-Mirtazapine tablets 30mg are used to treat episodes of major depression to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. APO-Mirtazapine tablets 30mg are also used to prevent relapse of depression. APO-Mirtazapine tablets 30mg also have sedative properties.
How does APO-Mirtazapine work?
APO-Mirtazapine tablets 30mg contain mirtazapine, which is an antidepressant belonging to the class of drugs known as tetracyclic antidepressant. It is also classified as a Noradrenergic and Specific Seratonergic Antidepressant (NaSSA), because it acts as an antagonist of alpha adrenergic receptors in the central nervous system, which in turn increases the amount of noradrenaline and serotonin neurotransmitters (brain chemical that allows nerve cells to communicate). Mirtazapine in APO-Mirtazapine tablets 30mg has several pharmacological properties, due to its interaction with several chemicals and numerous neurotransmitter systems that are thought to be involved in depression. These include blocking the effect of histamine, which explains its sedative properties. Also Mirtazapine in APO-Mirtazapine tablets 30mg blocks certain serotonin receptors, which prevents some of the side effects seen with antidepressants of the Selective Serotonin Reuptake Inhibitors (SSRI) and it does not have any effect as a reuptake inhibitor, which is how most SSRIs and SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors) work. The action of Mirtazapine in APO-Mirtazapine tablets 30mg helps correct the chemical imbalance caused by a lack of certain neurotransmitters that is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin, which controls many body activities, including regulating mood.
What does APO-Mirtazapine contain?
APO-Mirtazapine tablets 30mg contain the active ingredient mirtazapine, a tetracyclic antidepressant classified as a Noradrenergic and Specific Seratonergic Antidepressant (NaSSA), used to treat and relieve symptoms of major depression. They also contain lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose, hydroxypropyl cellulose, macrogol 8000, titanium dioxide (E171), ferric oxide (red iron oxide) (E172), ferric oxide (yellow iron oxide) (E172)
Treating depression with APO-Mirtazapine
APO-Mirtazapine tablets 30mg contain mirtazapine, a tetracyclic antidepressant used to treat episodes of major depression to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. APO-Mirtazapine tablets 30mg are also used to prevent relapse of depression. Mirtazapine in APO-Mirtazapine tablets 30mg interacts with several chemicals and numerous neurotransmitter systems that are thought to be involved in depression. These include blocking alpha adrenergic receptors in the central nervous system, which in turn increases the amount of noradrenaline and serotonin neurotransmitters (brain chemical that allows nerve cells to communicate). This action of Mirtazapine in APO-Mirtazapine tablets 30mg helps correct the chemical imbalance caused by a lack of these neurotransmitters, which is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin, which controls many body activities, including regulating mood. Mirtazapine in APO-Mirtazapine tablets 30mg also blocks certain serotonin receptors, which prevents some of the side effects seen with antidepressants of the Selective Serotonin Reuptake Inhibitors (SSRI) and it does not have any effect as a reuptake inhibitor, which is how most SSRIs and SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors) work.
What are the side effects of APO-Mirtazapine?
The most commonly reported side effects when taking APO-Mirtazapine tablets 30mg include: increase in appetite and weight gain, lethargy, drowsiness or sleepiness, headache, tiredness, dry mouth, nausea diarrhoea, vomiting, orthostatic hypotension or dizzy spell (low blood pressure when standing up), abnormal dreams, tremor, dizziness, painful joints, back pain, muscle aches and pains, oedema (swelling due to fluid accumulation), skin rash.
When should APO-Mirtazapine not be used?
You should not use APO-Mirtazapine tablets 30mg if you:
- are allergic to mirtazapine or any ingredients in APO-Mirtazapine
- are pregnant or are breastfeeding
- have kidney or liver disease
- have had a recent heart attack or have other heart problems like angina
- have certain conditions without discussion with your doctor, including low blood pressure, diabetes, glaucoma, problems in urinating due to an enlarged prostate,
- are taking any monoamine oxidase inhibitor medications (such as phenelzine, tranylcypromine and moclobemide) as these can cause serious reactions if taken with APO-Mirtazapine
- are taking medicines that interact with APO-Mirtazapine, including other antidepressants like the SNRI venlafaxine, the SSRI fluoxetine, lithium for bipolar, St John’s wort, benzodiazepines for anxiety, anticoagulants like warfarin, the antifungal ketoconazole, cimetidine for stomach ulcers, the antibiotic erythromycin, anticonvulsant carbamazepine, the antiepileptic phenytoin, alcohol
What medications interact with APO-Mirtazapine?
Several medications interact with APO-Mirtazapine tablets 30mg and should either not be taken while you are taking APO-Mirtazapine or only after discussion and instruction from your doctor:
- Drugs that cause a serious reaction with APO-Mirtazapine: monoamine oxidase inhibitor medications, like phenelzine, other antidepressants like the SNRI venlafaxine, the SSRI fluoxetine, lithium for bipolar, St John’s wort, alcohol
- Drugs that affect APO-Mirtazapine: the antifungal ketoconazole, cimetidine for stomach ulcers, the antibiotic erythromycin, anticonvulsant carbamazepine, the antiepileptic phenytoin
- Drugs that are affected by APO-Mirtazapine: benzodiazepines for anxiety, anticoagulants like warfarin
How should APO-Mirtazapine be taken?
You should take your APO-Mirtazapine tablets 30mg swallowed whole with a glass of water with or without food once daily, at the same times each day preferably at bedtime. The dose you take and for how long depends on your doctor’s recommendations how well you are responding to treatment. You should begin to feel an improvement within one to two weeks, with maximum effect within four weeks and you should continue to take your APO-Mirtazapine tablets 30mg for at least a further four to six months after you feel well.
How long should you take APO-Mirtazapine?
You should take your APO-Mirtazapine tablets 30mg regularly for as long as recommended by your doctor and you should begin to feel an improvement within one to two weeks, with maximum effect within four weeks. You should continue to take your APO-Mirtazapine tablets 30mg for at least a further four to six months after you feel well.
Missed dose of APO-Mirtazapine
If you miss a dose of APO-Mirtazapine take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should APO-Mirtazapine be stored?
You should store your APO-Mirtazapine below 25°C in a cool dry place.
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APO-Montelukast 10mg
Apo-Montelukast general information
What is Apo-Montelukast used for?
Apo-Montelukast tablets 10mg are used for treatment of asthma in adults and adolescents age over 15 years, for management of chronic asthma, to help prevent day-time and night-time symptoms, including coughing, wheezing and tightness of the chest; also exacerbations of asthma, but not to treat asthma attack. Apo-Montelukast tablets 10mg can be used in addition to other asthma medications, including inhaled corticosteroids and bronchodilators. Apo-Montelukast tablets 10mg are also used as prophylaxis to prevent exercise-induced asthma. Apo-Montelukast 10mg are also used to treat seasonal allergy to pollen (hay fever), and perennial allergy, such as to animal fur, mould and house dust mites. Both forms of allergy can cause allergic rhinitis with symptoms including nasal congestion, runny itchy nose, sneezing, tearing, itchy, red, and puffy eyes and problems sleeping.
How does Apo-Montelukast work?
Apo-Montelukast tablets 10mg contain montelukast sodium, which is a selective and orally active (can be taken in tablet form) leukotriene receptor antagonist that is used to prevent leukotriene-mediated inflammation in asthma and allergic rhinitis. Leukotrienes are chemicals produced by inflammatory cells like mast cells and eosinophils that are found in the airways and mediate the inflammatory responses. Montelukast in Apo-Montelukast tablets 10mg binds to specific receptors for the cysteinyl leukotrienes (LTC4, LTD4, LTE4) on the cells of the airways, including smooth muscle cells and also macrophages, which inhibits the action of leukotrienes. In asthma leukotriene-mediated effects cause bronchoconstriction (narrowing of the airways), inflammation, swelling and mucous secretion. In allergic rhinitis leukotrienes are released in the nasal passages after exposure to an allergen like pollen or house dust mites and cause irritation and inflammation. Apo-Montelukast tablets 10mg help prevent bronchoconstriction, mucous secretion, vascular permeability, and eosinophil recruitment to relieve symptoms of asthma and allergic rhinitis.
What does Apo-Montelukast contain?
Apo-Montelukast tablets 10mg contain the active ingredient montelukast sodium, which is a leukotriene receptor antagonist that prevents leukotriene-mediated inflammation in asthma and allergic rhinitis. They also contain lactose anhydrous, cellulose microcrystalline, croscarmellose sodium, silica (colloidal anhydrous), magnesium stearate, hypromellose, hydroxyproprylcellulose, yellow iron oxide, red iron oxide, titanium dioxide, purified water.
Treating asthma with Apo-Montelukast
Apo-Montelukast tablets 10mg contain montelukast, a leukotriene receptor antagonist that prevents leukotriene-mediated inflammation in asthma. Leukotrienes are chemicals that mediate inflammation and are involved in the pathophysiology asthma, causing bronchoconstriction (narrowing of the airways), swelling and mucous secretion. Montelukast in Apo-Montelukast tablets 10mg binds to the leukotriene receptors and block the action of leukotrienes in the airways, which helps to reduce asthma symptoms including coughing, wheezing and tightness of the chest. You should not use Apo-Montelukast tablets 10mg for asthma attack; for this you need a fast acting bronchodilator inhaler.
Treating allergy with Apo-Montelukast
Apo-Montelukast tablets 10mg contain montelukast, a leukotriene receptor antagonist that prevents leukotriene-mediated inflammation that is involved in the pathophysiology of allergic rhinitis. Leukotrienes are released in the nasal passages after exposure to an allergen like pollen or house dust mites and cause irritation and inflammation. Montelukast in Singulair tablets 10mg binds to the leukotriene receptors and blocks the action of leukotrienes in the nasal passages, which helps to reduce symptoms of allergic rhinitis like nasal congestion, runny nose and sneezing.
Should you take Apo-Montelukast with other asthma medications?
You can take Apo-Montelukast tablets 10mg as well as your other asthma medication, including inhaled bronchodilators and corticosteroids, only if recommended by your doctor.
What are the side effects of Apo-Montelukast?
The most commonly reported side effects when taking Apo-Montelukast tablets 10mg include abdominal pain and headache.
When should Apo-Montelukast not be used?
You should not use Apo-Montelukast tablets 10mg if you:
- are allergic to montelukast or any ingredients in Apo-Montelukast
- are taking phenobarbital which interacts with Apo-Montelukast tablets
- are under 15 years, you should take the chewable tablets for children instead
How should Apo-Montelukast be taken?
You should take your Apo-Montelukast tablets 10mg swallowed whole with a glass of water with or without food, once daily preferably in the evening. You should continue to take your Apo-Montelukast tablets 10mg for as long as recommended by your doctor, and for asthma you should continue to take your Apo-Montelukast tablets 10mg even if you feel better, as it is intended as a long-term medication to help control your asthma.
How long should you take Apo-Montelukast?
You should continue to take your Apo-Montelukast tablets 10mg for as long as recommended by your doctor, and for asthma you should continue to take your Apo-Montelukast tablets 10mg even if you feel better, as it is intended as a long-term medication to help control your asthma.
Missed dose of Apo-Montelukast
If you miss a dose of Apo-Montelukast tablets 10mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Apo-Montelukast be stored?
You should store your Apo-Montelukast below 25°C in a cool dry place and protect from heat and moisture.
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Feminization Regimen
A gender reassignment program for male to female transsexuals normally includes reducing androgen effects with spironolactone (cyproterone has been used in European countries) and stimulating feminization of secondary sex characteristics with estrogen.
There can be risks attached to hormone therapy in both men and women and therefore it is definitely inadvisable to take any form of hormone product unless it is medically prescribed.
The use of progesterone to augment breast development is controversial in physicians treating MTF transsexuals. When deciding on a hormone regimen, prescribers should remember that it is estrogen that causes the serious side effects, so the lowest effective dose should be used.
The manufacturers of oestrogen and progesterone products specify them for medical use in females and do not acknowledge their use for transsexuals, so there is little clinical data available regarding this usage.
Apart from a summary provided below, two excellent sites for information on hormones and dosages are:
http://www.scribd.com/doc/56618709/transsexual-transgendered-guide-to-obtaining-and-using-transsexual-hormones-hormone-replacement-therapy-hrt
Estrogens
Estrogen dosing regimens for gender transition vary widely. Estrogen should be prescribed at the lowest possible effective doses to avoid the serious complications of high-dose estrogen therapy.
Current recommendations for estrogen dosing range from starting doses of 0.625 to 2.5 mg of conjugated estrogen.
Estrogen is the most important part of any feminizing regimen.
Some typically-used estrogen dosages for pre-operative transsexual women who have not had an orchiectomy (castration) are as follows:
Oral Estrogens
Conjugated estrogens such as Premarin® 5 mg daily.
Estradiol such as Progynova (Oestradiol Valerate) or Estrofem 4 mg daily.
Injectable Estrogen
Progynon Depot is an alternative form of Oestradiol Valerate and comes in an injectable form.
Transdermal Estrogen
Estradiol 0.1 mg patch, changed twice weekly. Transdermal patches uniformly contain estradiol as the active medication, produced in 0.05mg (50 mcg), 0.075mg (75 mcg) and 0.1 mg (100 mcg) concentrations, and are branded under a variety of names such as Estradot / Vivelle, Climara and Estraderm.
Transdermal estrogen causes less clotting tendency than oral estrogen, possibly important to some patients; but this is a very expensive product.
Estrogen Gels
If you do not wish to use estradiol patches, an option is estradiol gel applied daily to the skin. The gel is usually alcohol based and is absorbed through the skin. The medication imparted into the skin usually takes about 12 hours for absorption into the blood stream, which produces a similar continuous action like the patch. Gels have the advantage as the wearer is not burdened with wearing a patch and the potential irritation from the adhesive that holds the patch in place.
Gels roughly corresponds to the daily doses found in the 50 mcg and 100 mcg patches.
Sandrena is an Estradiol Gel which comes in 1 gram sachets.
Estrodose Gel is the same as Estrogel. It is a clear, odorless, hydro-alcoholic gel that provides for delivery of estradiol for estrogen replacement in a non-patch transdermal form.
Other Forms of Estrogen
(!SITE_NAME!) is able to provide three other forms of Estrogen these are Premarin Cream which is a conjugated Estrogen Cream and Ovestin which is a low dose Estriol Cream.
Aerodiol - Aerodiol nasal spray containing estradiol hemihydrate 150µg per spray has been launched by Servier Laboratories The product is licensed for replacement therapy for oestrogen deficiency symptoms in postmenopausal women.
Serious health risks of estrogen therapy include stroke, pulmonary embolism, myocardial infarction, and breast cancer.
Combination estrogen and progesterone
(!SITE_NAME!) is able to supply Kliogest and Kliovance / Activelle, a combination of oestradiol and norethisterone and is used to produce female hormones estrogen and progesterone.
Antiandrogens
Besides providing estrogen, a hormone regimen should also reduce testosterone to normal female levels. This usually requires adding an anti-androgen.
Spironolactone acts as an antiandrogen of testosterone to dihydrotestosterone. Spironolactone in doses of 200–400 mg per day allows the practitioner to decrease exogenous estrogen doses tophysiologic or “hormone replacement” levels while still obtaining desired effects of breast development, feminization of skin, and female fat distribution.
Spironolactone can usually be discontinued after sex reassignment surgery.
Androcur (Cyproterone acetate) is a powerful antiandrogen and progestagen used in Europe for transgendered patients. Its use is limited by interference with corticosteroid production, high cost, and side effect profile.
Cyproterone is a generic form of Androcur. It performs is exactly same way as Androcur but at a cheaper cost.
Finasteride is an antiandrogen that opposes the formation of DHT, but not of testosterone itself. Finasteride is present in Proscar in a 5mg dosage and in Propecia in a 1mg doasge.
Dutasteride is also an antiandrogen that opposes the formation of DHT, but not of testosterone itself.
There are several other antiandrogens which are used for other indications but have no reported data in the transgendered patient. Flutamide and Bicalutamide are nonsteroidal antiandrogens normally used in the management of Management of Prostate Cancer.
Progesterone
Progesterone is the third and optional component of the MTF regimen.
Medroxyprogesterone is available as Provera and Depo-Provera. Medroxyprogesterone is a weak antiandrogen, and testosterone suppression may be accomplished with lower doses of estrogen. Medroxyprogesterone is less androgenic than norethindrone and orgestrel.
Micronized Progesterone is advantageous because it has a more favorable side effect profile (anxiety and irritability) than medroxyprogesterone. It is also less androgenic when higher progesterone doses are needed, but is more costly. Micronized progesterone is available as Prometrium or in a generic form as Microgest.
Duphaston (Dydrogesterone) may be used as an alternative to medroxyprogesterone acetate. It is not metabolised into testosterone within the body, and is therefore free of the virilising effects which some patients experience ftom other progesterones. A typical pre-op (or early post-op) dose would be 20mg in two doses, reducing to a single dose of 10mg daily post-op.
Crinone is another medication available and contains the female hormone progesterone.
Cyproterone plus Estrogen
While Androcur is available in 50 mg tablets, sometimes Diane-35 is used when small doses are desired. Diane-35 is a contraceptive with anti-acne properties (due to the cyproterone contained), and is comprised of 2 mg of cyproterone acetate and 0.035 mg ethinyl estradiol. Diane-35 generics are available.
(!SITE_NAME!) can supply Diane 35 which is comprised of 2 mg of cyproterone acetate and 0.035 mg ethinyl estradiol.
A generic form of Diane 35 is also available, this is manufactured by Cipla and is known as Ginette 35.
Climen is also a combination of an Estrogen with Cyproterone. Climen is normally used in Hormone Replacement Therapy Calendar-pack containing 11 tablets of 2 mg estradiol-17-valerate each, plus 10 tablets of 2 mg estradiol-17-valerate and 1 mg cyproterone acetate each. Brandnames in other countries - Climene, Climen/Clisin.
Facial Hair Reduction
Eflora / Vaniqa Cream is used for the reduction of unwanted facial hair. Eflora / Vaniqa Cream does not remove hair, it slows the regrowth.
Antagonists
Anastrozole is a non-steroidal aromatase inhibitor that decreases the amount of estrogen the body makes.
Arimidex contains the active ingredient anastrozole to decrease the body's production of estrogen.
(!SITE_NAME!) are unable to provide advice on treatment regimes. However the following sites may be of some assistance.
Transsexual Women's Resources
TransGenderCare - An educational offering of the Tampa Gender Identity Program. Has useful features on hormones and medical care.
http://www.transgendercare.com
and another excellent site is
http://www.scribd.com/doc/56618709/transsexual-transgendered-guide-to-obtaining-and-using-transsexual-hormones-hormone-replacement-therapy-hrt
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APO-Mirtazapine 45mg
APO-Mirtazapine general information
What is APO-Mirtazapine used for?
APO-Mirtazapine tablets 45mg are used to treat episodes of major depression to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. APO-Mirtazapine tablets 45mg are also used to prevent relapse of depression. APO-Mirtazapine tablets 45mg also have sedative properties.
How does APO-Mirtazapine work?
APO-Mirtazapine tablets 45mg contain mirtazapine, which is an antidepressant belonging to the class of drugs known as tetracyclic antidepressant. It is also classified as a Noradrenergic and Specific Seratonergic Antidepressant (NaSSA), because it acts as an antagonist of alpha adrenergic receptors in the central nervous system, which in turn increases the amount of noradrenaline and serotonin neurotransmitters (brain chemical that allows nerve cells to communicate). Mirtazapine in APO-Mirtazapine tablets 45mg has several pharmacological properties, due to its interaction with several chemicals and numerous neurotransmitter systems that are thought to be involved in depression. These include blocking the effect of histamine, which explains its sedative properties. Also Mirtazapine in APO-Mirtazapine tablets 45mg blocks certain serotonin receptors, which prevents some of the side effects seen with antidepressants of the Selective Serotonin Reuptake Inhibitors (SSRI) and it does not have any effect as a reuptake inhibitor, which is how most SSRIs and SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors) work. The action of Mirtazapine in APO-Mirtazapine tablets 45mg helps correct the chemical imbalance caused by a lack of certain neurotransmitters that is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin, which controls many body activities, including regulating mood.
What does APO-Mirtazapine contain?
APO-Mirtazapine tablets 45mg contain the active ingredient mirtazapine, a tetracyclic antidepressant classified as a Noradrenergic and Specific Seratonergic Antidepressant (NaSSA), used to treat and relieve symptoms of major depression. They also contain lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose, hydroxypropyl cellulose, macrogol 8000, titanium dioxide (E171), ferric oxide (red iron oxide) (E172), ferric oxide (yellow iron oxide) (E172)
Treating depression with APO-Mirtazapine
APO-Mirtazapine tablets 45mg contain mirtazapine, a tetracyclic antidepressant used to treat episodes of major depression to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. APO-Mirtazapine tablets 45mg are also used to prevent relapse of depression. Mirtazapine in APO-Mirtazapine tablets 45mg interacts with several chemicals and numerous neurotransmitter systems that are thought to be involved in depression. These include blocking alpha adrenergic receptors in the central nervous system, which in turn increases the amount of noradrenaline and serotonin neurotransmitters (brain chemical that allows nerve cells to communicate). This action of Mirtazapine in APO-Mirtazapine tablets 45mg helps correct the chemical imbalance caused by a lack of these neurotransmitters, which is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin, which controls many body activities, including regulating mood. Mirtazapine in APO-Mirtazapine tablets 45mg also blocks certain serotonin receptors, which prevents some of the side effects seen with antidepressants of the Selective Serotonin Reuptake Inhibitors (SSRI) and it does not have any effect as a reuptake inhibitor, which is how most SSRIs and SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors) work.
What are the side effects of APO-Mirtazapine?
The most commonly reported side effects when taking APO-Mirtazapine tablets 45mg include: increase in appetite and weight gain, lethargy, drowsiness or sleepiness, headache, tiredness, dry mouth, nausea diarrhoea, vomiting, orthostatic hypotension or dizzy spell (low blood pressure when standing up), abnormal dreams, tremor, dizziness, painful joints, back pain, muscle aches and pains, oedema (swelling due to fluid accumulation), skin rash.
When should APO-Mirtazapine not be used?
You should not use APO-Mirtazapine tablets 45mg if you:
- are allergic to mirtazapine or any ingredients in APO-Mirtazapine
- are pregnant or are breastfeeding
- have kidney or liver disease
- have had a recent heart attack or have other heart problems like angina
- have certain conditions without discussion with your doctor, including low blood pressure, diabetes, glaucoma, problems in urinating due to an enlarged prostate,
- are taking any monoamine oxidase inhibitor medications (such as phenelzine, tranylcypromine and moclobemide) as these can cause serious reactions if taken with APO-Mirtazapine
- are taking medicines that interact with APO-Mirtazapine, including other antidepressants like the SNRI venlafaxine, the SSRI fluoxetine, lithium for bipolar, St John’s wort, benzodiazepines for anxiety, anticoagulants like warfarin, the antifungal ketoconazole, cimetidine for stomach ulcers, the antibiotic erythromycin, anticonvulsant carbamazepine, the antiepileptic phenytoin, alcohol
What medications interact with APO-Mirtazapine?
Several medications interact with APO-Mirtazapine tablets 45mg and should either not be taken while you are taking APO-Mirtazapine or only after discussion and instruction from your doctor:
- Drugs that cause a serious reaction with APO-Mirtazapine: monoamine oxidase inhibitor medications, like phenelzine, other antidepressants like the SNRI venlafaxine, the SSRI fluoxetine, lithium for bipolar, St John’s wort, alcohol
- Drugs that affect APO-Mirtazapine: the antifungal ketoconazole, cimetidine for stomach ulcers, the antibiotic erythromycin, anticonvulsant carbamazepine, the antiepileptic phenytoin
- Drugs that are affected by APO-Mirtazapine: benzodiazepines for anxiety, anticoagulants like warfarin
How should APO-Mirtazapine be taken?
You should take your APO-Mirtazapine tablets 45mg swallowed whole with a glass of water with or without food once daily, at the same times each day preferably at bedtime. The dose you take and for how long depends on your doctor’s recommendations how well you are responding to treatment. You should begin to feel an improvement within one to two weeks, with maximum effect within four weeks and you should continue to take your APO-Mirtazapine tablets 45mg for at least a further four to six months after you feel well.
How long should you take APO-Mirtazapine?
You should take your APO-Mirtazapine tablets 45mg regularly for as long as recommended by your doctor and you should begin to feel an improvement within one to two weeks, with maximum effect within four weeks. You should continue to take your APO-Mirtazapine tablets 45mg for at least a further four to six months after you feel well.
Missed dose of APO-Mirtazapine
If you miss a dose of APO-Mirtazapine take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should APO-Mirtazapine be stored?
You should store your APO-Mirtazapine below 25°C in a cool dry place.
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Psoriasis Treatments
What is psoriasis?
Psoriasis is a non-allergic, chronic skin condition that has a genetic predisposition and can affect anyone at any age. It is characterised by red scaly patches of skin ranging from mild, with a few patches usually at the backs of the knees and elbows, and minimal discomfort, to severe with psoriatic lesions covering large areas of the body and causing extreme itching, pain and discomfort. Psoriasis is thought to be an automimmune disease, where certain cells of the immune system (T lymphocytes) are triggered to overproduce inflammatory chemicals, particularly TNF alpha, a cytokine that stimulates excessive growth and proliferation of keratinocytes (epidermal skin cells), causing thickening and scaling of the skin as well as inflammation.
Treatment for psoriasis
Calcipotriol is a derivative of calcitriol or Vitamin D (also known as 1,25 dihydroxycholecalciferol or 1,25(OH)2D3). Vitamin D is primarily involved regulating calcium metabolism but has other actions including inhibition of cell proliferation, stimulation of cell differentiation and immunomodulation. Calcipotriol binds to the same receptor in skin cells as Vitamin D and has the same activity in regulating cell growth and differentiation but is less effective in terms of calcium metabolism. Calcipotriol is used as a topical treatment for psoriasis and helps to prevent over production of hardened keratinocytes and restores normal cell growth and behaviour to the epidermal skin cells.
Tazarotene is a retinoid pro-drug of Vitamin A that affects skin cell behaviour and helps reverse abnormal changes in keratinocyte behaviour; it also has anti-inflammatory properties.
Both medications reduce the inflammation, scaling and thickening of psoriatic plaques and relieve symptoms of psoriasis.
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