section name header

Pronunciation

meer-TAZ-a-peen

Classifications

Therapeutic Classification: antidepressants

Pharmacologic Classification: tetracyclic antidepressants

Indications

BEERS REMS


Unlabeled Use:

Action

  • Potentiates the effects of norepinephrine and serotonin.
Therapeutic effects:
  • Antidepressant action, which may develop only after several wk.

Pharmacokinetics

Absorption: Well absorbed but rapidly metabolized, resulting in 50% bioavailability.

Distribution: Unknown.

Protein Binding: 85%.

Metabolism/Excretion: Extensively metabolized by the liver by the CYP1A2, CYP2D6, and CYP3A isoenzymes; metabolites excreted in urine (75%) and feces (15%).

Half-Life: 20–40 hr.

Time/Action Profile

(antidepressant effect)

ROUTEONSETPEAKDURATION
PO1–2 wk6 wk or moreunknown



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: edema, hypotension

Derm: BULLOUS DERMATITIS, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), ERYTHEMA MULTIFORME, pruritus, rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS

EENT: sinusitis

Endo: SIADH

F and E: thirst, hyponatremia

GI: appetite, constipation, dry mouth, liver enzymes, abdominal pain, anorexia, nausea, vomiting

GU: urinary frequency

Hemat: AGRANULOCYTOSIS

Metab: weight gain, hypercholesterolemia, hypertriglyceridemia

MS: arthralgia, back pain, myalgia

Neuro: drowsiness, abnormal dreams, abnormal thinking, agitation, akathisia, anxiety, apathy, confusion, dizziness, hyperkinesia, hypoesthesia, malaise, NEUROLEPTIC MALIGNANT SYNDROME, SUICIDAL THOUGHTS, twitching, weakness

Resp: cough, dyspnea

Misc: flu-like syndrome, SEROTONIN SYNDROME

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Remeron, Remeron SolTab

Canadian Brand Names

Remeron RD

Code

NDC Code