Myrox SR
Generic Name
Mirtazapine
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| myrox sr 75 mg capsule | ৳ 5.04 | ৳ 50.40 |
Description
Overview of the medicine
Myrox SR contains Mirtazapine, an antidepressant used to treat major depressive disorder. The SR (sustained-release) formulation provides a prolonged therapeutic effect.
Uses & Indications
Dosage
Adults
Typically, initial dose is 15 mg once daily, preferably in the evening. May be increased up to a maximum of 45 mg daily based on response.
Elderly
Lower initial dose (e.g., 7.5 mg) and careful titration are recommended due to potential for reduced clearance and increased sensitivity.
Renal_impairment
Dose adjustment required. For severe renal impairment, consider a 50% dose reduction.
How to Take
Take orally once daily, preferably in the evening before bedtime. Swallow the tablet whole; do not crush, chew, or divide.
Mechanism of Action
Mirtazapine works by increasing the activity of certain neurotransmitters in the brain, such as norepinephrine and serotonin. It blocks alpha-2 adrenergic presynaptic receptors and 5-HT2 and 5-HT3 receptors.
Pharmacokinetics
Onset
Therapeutic effects may take 1-2 weeks; sleep improvement may be seen earlier.
Excretion
Primarily via urine (approximately 75%) and feces (approximately 15%).
Half life
20-40 hours (average 26 hours), allowing for once-daily dosing.
Absorption
Rapidly absorbed after oral administration; sustained-release formulation provides prolonged absorption. Peak plasma concentrations reached within hours.
Metabolism
Extensively metabolized in the liver by CYP1A2, CYP2D6, and CYP3A4 enzymes.
Side Effects
Contraindications
- Hypersensitivity to Mirtazapine or any excipients
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI
Drug Interactions
MAOIs
Risk of serotonin syndrome. Avoid concomitant use.
Warfarin
May increase prothrombin time and INR; monitor coagulation parameters.
SSRIs, SNRIs, Triptans
Increased risk of serotonin syndrome.
CYP inhibitors (e.g., ketoconazole, cimetidine)
May increase Mirtazapine plasma levels. Dose adjustment may be necessary.
CNS Depressants (e.g., alcohol, benzodiazepines)
Increased CNS depressant effects. Avoid concomitant use.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, disorientation, tachycardia, impaired consciousness, and possibly mild hypertension or hypotension. Treatment is symptomatic and supportive; no specific antidote. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Limited data suggest excretion into breast milk; use with caution and monitor the infant for adverse effects during lactation.
Side Effects
Contraindications
- Hypersensitivity to Mirtazapine or any excipients
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI
Drug Interactions
MAOIs
Risk of serotonin syndrome. Avoid concomitant use.
Warfarin
May increase prothrombin time and INR; monitor coagulation parameters.
SSRIs, SNRIs, Triptans
Increased risk of serotonin syndrome.
CYP inhibitors (e.g., ketoconazole, cimetidine)
May increase Mirtazapine plasma levels. Dose adjustment may be necessary.
CNS Depressants (e.g., alcohol, benzodiazepines)
Increased CNS depressant effects. Avoid concomitant use.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, disorientation, tachycardia, impaired consciousness, and possibly mild hypertension or hypotension. Treatment is symptomatic and supportive; no specific antidote. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Limited data suggest excretion into breast milk; use with caution and monitor the infant for adverse effects during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory authorities
Patent Status
Off-patent (generic available)
Clinical Trials
Mirtazapine has undergone extensive clinical trials demonstrating its efficacy and safety in the treatment of major depressive disorder, showing significant improvements in depressive symptoms compared to placebo.
Lab Monitoring
- Monitor complete blood count (CBC) periodically, especially if fever, sore throat, or other signs of infection develop (due to risk of agranulocytosis).
- Monitor liver function tests (LFTs) periodically, especially in patients with pre-existing hepatic impairment.
- Monitor weight and metabolic parameters.
Doctor Notes
- Advise patients about the delayed onset of action for antidepressant effects and the importance of continued treatment.
- Monitor closely for suicidal ideation, especially at the initiation of therapy and during dose adjustments.
- Counsel patients on potential for increased appetite and weight gain, and suggest lifestyle modifications.
- Caution against abrupt discontinuation to avoid withdrawal symptoms.
Patient Guidelines
- Do not stop taking this medicine abruptly without consulting your doctor, as withdrawal symptoms may occur.
- Avoid driving or operating machinery until you know how this medicine affects your alertness.
- Report any suicidal thoughts or unusual changes in mood or behavior to your doctor immediately.
- Be aware of potential weight gain and increased appetite.
- Avoid alcohol while on this medication.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it's nearly time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Myrox SR may cause drowsiness, dizziness, and impaired concentration. Patients should be warned about engaging in hazardous activities requiring complete mental alertness, such as driving or operating heavy machinery.
Lifestyle Advice
- Maintain a healthy and balanced diet to manage potential weight gain.
- Engage in regular physical activity.
- Practice good sleep hygiene, as Mirtazapine can cause drowsiness.
- Avoid smoking, as it may affect metabolism.
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