Adult Dosing
Major depressive disorder
- Initial: Start 15 mg PO qhs
- Titrate: Increase at 1-2 week intervals; usual range: 15 - 45 mg PO qhs; Max: 45 mg/day
- Geriatric: Dosage adjustment may be needed due to decreased clearance
- Do not cut/crush/chew ODT form
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Observe patients for worsening depression or the emergence of suicidality, anxiety, agitation, panic attacks, particularly early in therapy or after increases in dose
- Families and caregivers should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms as well as the emergence of suicidality, and to report such symptoms immediately to healthcare providers
- Patients with depressive symptoms should be adequately screened prior to initiating treatment to determine if they are at risk for bipolar disorder
- Therapy may cause agranulocytosis, neutropenia. Suspend therapy if a patient develops a sore throat, fever, stomatitis or other signs of infection, along with a low WBC count
- Mirtazapine should not be used in combination with an MAOI, or within 14 days of initiating or discontinuing therapy with an MAOI
- Gradually taper when discontinuing to avoid withdrawal symptoms
- Use with caution in hepatic impairment. Transaminase elevations may occur with symptoms of compromised liver function
- It may impair judgment, thinking, or motor skills. Engaging in hazardous activities can be dangerous
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment
- History of seizure disorders
- Cardiovascular disorders
- Hypotension
- Hypovolemia
- Dehydration
- Cerebrovascular diseases
- Hyperthyroid patients
- History of schizophrenia
- History of or bipolar disorder
- Elderly patients
Pregnancy Category:C
Breastfeeding: Limited information indicates that maternal doses 
120 mg/day produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 5 April 2011). According to manufacturer data, patients should be advised to notify their physician if they are breastfeeding an infant.
Pricing data from www.DrugStore.com in U.S.A.
- Mirtazapine 15 MG TBDP [Box] (PRASCO LABORATORIES)
30 mg = $72.99
90 mg = $207.97 - Remeron SolTab 15 MG TBDP [Box] (ORGANON)
30 mg = $105.99
90 mg = $317.97 - Mirtazapine 30 MG TABS [Bottle] (AUROBINDO PHARMA USA)
30 mg = $49.99
90 mg = $145.96 - Mirtazapine 45 MG TBDP [Box] (PRASCO LABORATORIES)
30 mg = $74.99
90 mg = $214.97 - Mirtazapine 15 MG TABS [Bottle] (AUROBINDO PHARMA USA)
30 mg = $55.99
90 mg = $149.98 - Mirtazapine 7.5 MG TABS [Bottle] (GREENSTONE)
30 mg = $49.99
90 mg = $139.97 - Remeron SolTab 30 MG TBDP [Box] (ORGANON)
30 mg = $109.99
90 mg = $295.98 - Remeron 45 MG TABS [Bottle] (ORGANON)
30 mg = $139.99
90 mg = $403.43 - Mirtazapine 45 MG TABS [Bottle] (AUROBINDO PHARMA USA)
30 mg = $46.99
90 mg = $118.96 - Remeron SolTab 45 MG TBDP [Box] (ORGANON)
30 mg = $119.99
90 mg = $319.96 - Mirtazapine 30 MG TBDP [Box] (PRASCO LABORATORIES)
30 mg = $79.99
90 mg = $219.98 - Remeron 30 MG TABS [Bottle] (ORGANON)
30 mg = $134.98
90 mg = $383.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
