What does it do?

Mirtazapine is used to treat and prevent depression, and sometimes other conditions.

How should you take it?

Take mirtazapine regularly as directed with a glass of water, usually at night-time. Swallow the tablets whole.

What if you forget a dose?

Take the missed dose as soon as possible. If it is close to the time for your next dose, skip the missed dose and carry on as normal. Do not take two doses at the same time.

Can you take other medicines?

Some medicines available without a prescription may react with mirtazapine including:

• cold and flu medicines containing dextromethorphan (e.g. Robitussin Dry Cough Forte®)
• other medicines that may cause drowsiness (e.g. pain-killers, anti-nausea and cough/cold medicines – ask your pharmacist)
• some migraine medicines, such as sumatriptan (e.g. Sumagran Active®) or zolmitriptan (e.g. Zomig®)

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products (e.g. St John's wort) or recreational drugs (e.g. ecstasy).

What side effects might you notice?

Side Effects	Recommended action
Suicidal thoughts Change in heartbeat Muscle twitching or shaking you can’t control, confusion, heavy sweating, fever Chills, sore throat, tiredness	Tell your doctor immediately
Anxiety	Tell your doctor
Drowsiness, dizziness, weakness Strange dreams Dry mouth, change of appetite, weight gain Joint, muscle or bone aches and pains Constipation, stomach upset	Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• Tell your doctor if you have heart, kidney, prostate or liver problems; glaucoma, bipolar disorder, diabetes, or if you have ever had a seizure.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Mirtazapine can impair your ability to do tasks such as driving or using machines. Alcohol makes this worse. Discuss your risk with your health professional. (search NZTA - Are you safe to drive?)
• It may take a few weeks for mirtazapine to start working.
• Feelings of anxiety in the first few weeks of therapy are common, but should get better. Discuss with your doctor.
• If your depression continues to get worse, see your doctor.
• Do not stop taking mirtazapine without talking to your doctor first.