Zispin
Generic Name
Mirtazapine
Manufacturer
Organon
Country
Netherlands (original developer)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zispin 30 mg tablet | ৳ 15.00 | ৳ 210.00 |
Description
Overview of the medicine
Mirtazapine is an antidepressant medication used to treat major depressive disorder. It works by affecting certain neurotransmitters in the brain, helping to improve mood.
Uses & Indications
Dosage
Adults
Initial dose 15 mg daily, gradually increased based on response up to a maximum of 45 mg daily. 30 mg is a common therapeutic dose.
Elderly
Similar to adult dosage, but caution is advised with initial dose and titration, monitoring for adverse effects.
Renal_impairment
Dosage reduction recommended in moderate to severe renal impairment (CrCl < 40 mL/min). Max 30 mg daily for CrCl 10-40 mL/min, max 15 mg daily for CrCl < 10 mL/min.
How to Take
Orally, usually once daily at bedtime due to sedative effects. Can be taken with or without food.
Mechanism of Action
Mirtazapine acts as an α2-adrenergic receptor antagonist, leading to an increase in noradrenergic and serotonergic neurotransmission. It also blocks 5-HT2 and 5-HT3 receptors and is a potent antagonist of H1 histamine receptors, which contributes to its sedative effects.
Pharmacokinetics
Onset
Initial antidepressant effects may be seen within 1-2 weeks, full effect in 2-4 weeks.
Excretion
Excreted primarily in urine (approximately 75%) and feces (approximately 15%) as metabolites.
Half life
20-40 hours (average 26 hours).
Absorption
Rapidly and well absorbed after oral administration, peak plasma concentrations reached within 2 hours.
Metabolism
Extensively metabolized in the liver by demethylation and hydroxylation, followed by glucuronide conjugation. CYP2D6, CYP1A2, and CYP3A4 enzymes are involved.
Side Effects
Contraindications
- •Hypersensitivity to mirtazapine or any excipients
- •Concomitant use with MAO inhibitors or within 14 days of discontinuing an MAO inhibitor
Drug Interactions
MAO inhibitors
Serious, sometimes fatal, reactions including serotonin syndrome.
CNS depressants (e.g., benzodiazepines, alcohol)
Additive sedative effects.
Other serotonergic drugs (e.g., SSRIs, triptans, fentanyl)
Increased risk of serotonin syndrome.
CYP3A4 inhibitors (e.g., ketoconazole, protease inhibitors)
Increase mirtazapine plasma levels.
CYP3A4 inducers (e.g., carbamazepine, phenytoin, rifampicin)
Decrease mirtazapine plasma levels.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms typically include disorientation, somnolence, impaired memory, and tachycardia. Management is symptomatic and supportive; no specific antidote. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Small amounts excreted in breast milk, caution advised. Consult doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years.
Availability
Pharmacies, hospitals
Approval Status
Approved worldwide by various regulatory bodies (e.g., FDA, MHRA, DGDA)
Patent Status
Expired
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