Zispin
Generic Name
Mirtazapine
Manufacturer
Organon
Country
Netherlands / USA
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zispin 15 mg tablet | ৳ 8.06 | ৳ 112.84 |
Description
Overview of the medicine
Mirtazapine is an antidepressant medication used to treat major depressive disorder. It belongs to the noradrenergic and specific serotonergic antidepressant (NaSSA) class of drugs. It is known for its sedative properties and also helps improve sleep and appetite.
Uses & Indications
Dosage
Adults
Initially 15 mg once daily, preferably at bedtime. May be increased up to a maximum of 45 mg/day based on response and tolerability.
Elderly
Similar to adult dosage, but caution and slower titration may be advised due to potential for reduced renal/hepatic function. Start with 7.5 mg and gradually increase.
Renal_impairment
Dosage adjustment may be necessary for severe renal impairment (CrCl <30 mL/min). Consider reducing dose by 50%.
How to Take
Oral. Swallow the tablet whole with water. Can be taken with or without food. Typically taken once daily in the evening or at bedtime due to its sedative effects.
Mechanism of Action
Mirtazapine enhances noradrenergic and serotonergic neurotransmission. It acts as an antagonist at central pre-synaptic alpha2-adrenergic autoreceptors and heteroreceptors, thereby increasing the release of norepinephrine and serotonin. It also antagonizes postsynaptic 5-HT2 and 5-HT3 receptors and histamine H1 receptors.
Pharmacokinetics
Onset
Antidepressant effects may take 1-2 weeks. Sedative effects usually within 30-60 minutes.
Excretion
Primarily via urine (75%) and feces (15%) within a few days.
Half life
20-40 hours
Absorption
Rapidly absorbed after oral administration. Peak plasma concentrations reached within approximately 2 hours. Bioavailability approximately 50%.
Metabolism
Extensively metabolized in the liver via demethylation and hydroxylation by cytochrome P450 enzymes (CYP2D6, CYP1A2, CYP3A4), followed by conjugation.
Side Effects
Contraindications
- •Hypersensitivity to mirtazapine or any excipients
- •Concomitant use with MAO inhibitors (or within 14 days of discontinuing an MAOI)
Drug Interactions
Warfarin
Possible increase in INR and bleeding risk.
MAO inhibitors
Increased risk of serotonin syndrome, which can be fatal.
CNS depressants (benzodiazepines, alcohol)
Enhanced sedative effects and impaired cognitive/motor function.
Other serotonergic drugs (SSRIs, SNRIs, triptans)
Increased risk of serotonin syndrome.
Strong CYP3A4 inducers (e.g., carbamazepine, phenytoin)
Decreased mirtazapine plasma levels, potentially reducing efficacy.
Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
Increased mirtazapine plasma levels, potentially leading to increased side effects.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms include disorientation, impaired memory, tachycardia, and somnolence. Management is symptomatic and supportive; maintain airway, monitor cardiac function, and administer activated charcoal if recent ingestion. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Studies show limited data, but potential for adverse neonatal effects. Mirtazapine is excreted in breast milk; caution advised during lactation and potential risk/benefit should be considered.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Expired
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