According to the instructions, "Mirtazapine" should be used very carefully in the following cases:
- in the presence of defects in urination;
- with diabetes.
This drug should also not be combined with alcohol, as this can cause nausea. If violations of the liver and kidneys are noted, the patient is advised not to use this antidepressant, since its main active ingredient will affect these organs. mirtazapine cheap online In addition, antidepressants are usually not used in complex treatment..
Pharmacological action - antidepressant.
Blocks central presynaptic and postsynaptic alpha2-adrenergic inhibitory receptors, enhances central noradrenergic and serotonergic transmission. It is a strong antagonist of serotonin 5-HT2 and 5-HT3 receptors, practically does not interact with 5-HT1A and 5-HT1B receptors. Mirtazapine is also a strong antagonist of histamine H1 receptors, which determines its sedative effect. Weakly affects alpha1-adrenergic receptors and cholinergic receptors. The effect on peripheral alpha1-adrenergic and muscarinic receptors leads to the development of orthostatic hypotension and anticholinergic effects.
It is most effective in depressive conditions with the presence in the clinical picture of symptoms such as inability to experience pleasure and joy, loss of interest (anhedonia), psychomotor inhibition, sleep disturbance (especially in the form of early awakenings), weight loss, suicidal thoughts and lability of mood. In clinical conditions, anxiolytic and hypnotic properties are manifested, therefore, mirtazapine is effective for anxious depression. The antidepressant effect usually develops after 1–2 weeks of treatment.
Quickly and completely absorbed after ingestion, food intake does not practically affect the speed and completeness of absorption. Cmax is reached after 2 hours, absolute bioavailability is about 50%. Css in plasma is reached within 5 days and is proportional to the dose in the range of doses of 15–80 mg. At concentrations of 0.01-10 μg / ml, 85% binds to blood proteins. The main biotransformation pathways are demethylation and hydroxylation followed by conjugation of metabolites with glucuronic acid. Cytochrome P450 isoenzymes CYP2D6 and CYP1A2 are involved in the formation of the 8-hydroxy metabolite of mirtazapine, CYP3A4 in the formation of N-demethylated and N-oxidized metabolites. Some metabolites are pharmacologically active, but their plasma concentration is very low. It is excreted in urine (75% of the dose) and feces (15%). (-) - The enantiomer is excreted 2 times slower than the (+) - enantiomer. T1 / 2 is 20–40 hours (for men - 26 hours, for women - 37 hours). Mirtazapine clearance decreases with renal or liver failure.
> Use of the substance Mirtazapine
Hypersensitivity, concomitant use with MAO inhibitors.
The drug is available exclusively in tablet form, there are no other forms of release. http://www.medicinenet.com/mirtazapine/article.htm The tablets are film-coated yellow. The form of the drug is round. The tablets are packed in a blister of aluminum foil. One package contains from 20 to 40 tablets, and the manufacturer's instructions.