How does it work?

This medicine contains the active ingredient mirtazapine, which is a type of antidepressant. It works in the brain, where it enhances the effect of naturally occurring chemicals called neurotransmitters. Neurotransmitters are chemical compounds that act as chemical messengers between nerve cells. When depression occurs, there may be a decreased amount of the neurotransmitters noradrenaline and serotonin released from nerve cells in the brain. When noradrenaline and serotonin are released from nerve cells in the brain they act to lighten mood. When they are bound to nerve cells in the brain, they no longer have an effect on mood. Mirtazapine works by blocking receptors called alpha-2 receptors that are found on nerve cells in the brain. Noradrenaline and serotonin would normally bind to these receptors. By blocking them, mirtazapine prevents noradrenaline and serotonin from becoming bound to the nerve cells. This enhances the mood-lightening effect of noradrenaline and serotonin that is released from nerve cells, and helps relieve depression. It may take two to four weeks for the full benefits of treatment with mirtazapine to appear and you start to feel better.

What is it used for?

Depression

Warning!

If you experience any signs of infection while taking this medicine, such as flu-like symptoms, high temperature (fever), sore throat or inflammation of the lining of the mouth (stomatitis), you should tell your doctor immediately.

This medicine may cause low blood sodium levels (hyponatraemia), which can result in drowsiness, confusion, muscle twitching or convulsions. Consult your doctor if you develop any of these symptoms while taking this medicine.

Consult your doctor if you experience yellowing of the eyes or skin, or darkened urine while taking this medicine, as these may be signs of jaundice. Your doctor may ask you to stop taking this medicine if you do develop jaundice.

There is insufficient information regarding the safety and efficacy of this medicine in children. It is not recommended for children.

This medicine may cause dizziness, sleepiness and reduced concentration. If affected you should avoid potentially hazardous activities such as driving or operating machinary.

You should avoid suddenly stopping this medicine, as sudden withdrawal may result in headache, nausea, a general feeling of being unwell, agitation and anxiety. When it is time to stop taking this medicine it should be discontinued gradually, following the instructions given by your doctor or pharmacist.

You should avoid drinking alcohol while taking this medicine, as it will increase the risk of drowsiness and sedation.

Use with caution in

Angina pectoris

Behavioral or psychological problems caused by temporary or permanent dysfunction of the brain (organic brain syndrome)

Bipolar affective disorder (manic depression)

Closed angle glaucoma

Decreased kidney function

Decreased liver function

Defects of the heart's electrical message pathways, causing irregular heartbeats (heart conduction defects)

Diabetes mellitus

Difficulty in passing urine (urinary retention)

Elderly people

Enlarged prostate gland

Epilepsy

Heart disease

Increased pressure within the eye

Low blood pressure (hypotension)

People who have recently had a heart attack

Psychotic illness

Schizophrenia

Not to be used in

Breastfeeding

Pregnancy

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established. It is not recommended for use during pregnancy, and women of child-bearing potential should use an adequate method of contraception to prevent pregnancy while taking this medicine.

It is not known if this medicine passes into breast milk, therefore it is not recommended for use during breastfeeding.

Label warnings

This medication is to be swallowed whole, not chewed.

This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.

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