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.