Zispin
Generic Name
Mirtazapine
Manufacturer
Organon
Country
Netherlands
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zispin 75 mg tablet | ৳ 6.50 | ৳ 91.00 |
Description
Overview of the medicine
Zispin (Mirtazapine) is an antidepressant primarily used for the treatment of major depressive disorder. It helps improve mood and reduce anxiety.
Uses & Indications
Dosage
Adults
The usual starting dose is 15 mg once daily, preferably in the evening before sleep. The dose can be gradually increased based on clinical response and tolerability, up to a maximum of 45 mg/day. A 75 mg strength, while uncommon for typical tablet forms, may be used in specific severe cases or for certain formulations under strict medical supervision.
Elderly
Similar to adults, but slower titration and lower initial doses (e.g., 7.5 mg daily) may be considered due to potential for reduced renal/hepatic clearance.
Renal_impairment
Dose adjustment is necessary for patients with moderate to severe renal impairment (creatinine clearance <40 mL/min). A 25-50% dose reduction may be required.
How to Take
Take orally, once daily, preferably in the evening before sleep due to its sedative effects. May be taken with or without food.
Mechanism of Action
Mirtazapine enhances noradrenergic and serotonergic neurotransmission by antagonizing central pre-synaptic alpha2-adrenergic autoreceptors and heteroreceptors. It also blocks 5-HT2 and 5-HT3 receptors, further contributing to its antidepressant effects.
Pharmacokinetics
Onset
Clinical antidepressant effects typically observed within 1-2 weeks. Sedative effects may be observed sooner.
Excretion
Approximately 75% of the dose is excreted in urine and 15% in feces within 5 days.
Half life
Elimination half-life ranges from 20 to 40 hours (mean 26 hours), allowing for once-daily dosing.
Absorption
Rapidly and well-absorbed after oral administration, reaching peak plasma concentrations within approximately 2 hours.
Metabolism
Extensively metabolized in the liver, primarily via demethylation and oxidation by CYP1A2, CYP2D6, and CYP3A4, followed by glucuronidation.
Side Effects
Contraindications
- •Hypersensitivity to mirtazapine or any component of the formulation.
- •Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing MAOIs.
Drug Interactions
Warfarin
Mirtazapine may potentially increase INR, requiring careful monitoring.
Monoamine Oxidase Inhibitors (MAOIs)
Concomitant use is contraindicated due to risk of serotonin syndrome.
CYP Inducers (e.g., carbamazepine, rifampicin)
May decrease mirtazapine plasma concentrations, reducing efficacy.
CNS Depressants (e.g., alcohol, benzodiazepines)
May enhance the sedative effects of mirtazapine.
CYP Inhibitors (e.g., ketoconazole, cimetidine, fluvoxamine)
May increase mirtazapine plasma concentrations, requiring dose adjustment.
Serotonergic drugs (e.g., SSRIs, venlafaxine, tramadol, tryptophan)
Increased risk of serotonin syndrome.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include disorientation, drowsiness, impaired memory, tachycardia, and respiratory depression. Management is supportive and symptomatic, with gastric lavage or activated charcoal considered. Monitor vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Mirtazapine is excreted in breast milk; caution is advised when administered to a nursing mother. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Available in pharmacies
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Off-patent (generics available)
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Global Brand Names
International brand names for this medicine
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