Mirtazapine Prescription for Insomnia

Mirtazapine is prescribed to treat insomnia and depression. It belongs to a class of medications called antidepressants and has a sedating effect that makes it useful as a sleep aid.¹

Mirtazapine comes as a tablet and as a disintegrating tablet to take by mouth. It usually is taken once a day at bedtime. It may be taken with or without food. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand. Take mirtazapine exactly as directed. Do not take more or less of it, or take it more often than prescribed by your doctor.

It may take several weeks or longer for you to feel the full benefit of mirtazapine. Continue to take mirtazapine even if you feel well. Do not stop taking mirtazapine without talking to your doctor. Your doctor probably will decrease your dose gradually.

Mirtazapine may show some improvement in sleep in the first one to two weeks. Other symptoms, like depressed mood and lack of interest in activities, may take six to eight weeks to fully improve.²

Mirtazapine tablets come in dosages of 7.5 mg, 15 mg, 30 mg, and 45 mg.³

You can buy mirtazapine online with a prescription from RedBox Rx. Mirtazapine is not available over the counter.⁴

Mirtazapine starts at $20 per month with RedBox Rx. No insurance required.

Common side effects of mirtazapine include:

• Drowsiness.

• Dizziness.

• Anxiousness.

• Confusion.

• Increased weight and appetite.

• Dry mouth.

• Constipation.

• Nausea.

• Vomiting

Mirtazapine should only be taken at bedtime. If you miss a dose, do not take mirtazapine if you are not ready or able to go to sleep and stay asleep for at least seven to eight hours.

Before taking mirtazapine:

• Tell your doctor and pharmacist if you are allergic to mirtazapine, any other medications, or any of the ingredients in mirtazapine tablets or disintegrating tablets. Ask your doctor or pharmacist for a list of the ingredients.

• Tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), linezolid (ZYVOX)[JF1] , methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar) or tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take mirtazapine. If you stop taking mirtazapine, you should wait at least 14 days before you start to take an MAO inhibitor.

• Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven); antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin, imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil) or trimipramine (Surmontil); certain antifungals such as ketoconazole (Nizoral); buspirone; carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, other); cimetidine (Tagamet); diazepam (Valium); erythromycin (E.E.S., E-mycin, Erythrocin); fentanyl (Abstral, ACTIQ , Fentora, Onsolis, others); lithium (Eskalith, Lithobid); medications for migraine headaches such as almotriptan (Axert), eletriptan (RELPAX), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex) or zolmitriptan (Zomig); certain medications to treat HIV; medications for anxiety and seizures; nefazodone; phenytoin (Dilantin); rifampin (Rimactane, Rifadin, in Rifater, in Rifamate); sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil, Pexeva) or sertraline (Zoloft); selective serotonin and norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Pristiq), duloxetine (Cymbalta) or venlafaxine (Effexor); sleeping pills; tramadol (Ultram); or tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• Tell your doctor what herbal products you are taking, especially St. John's wort and tryptophan.

• Tell your doctor if you have or have ever had a heart attack, low blood pressure, heart, kidney or liver disease, or high cholesterol.

• Tell your doctor if you are pregnant, plan to become pregnant or are breastfeeding. If you become pregnant while taking mirtazapine, call your doctor.

• If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking mirtazapine.

• This medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. Alcohol can add to the drowsiness caused by this medication.

• If you have phenylketonuria (PKU), you should know that the orally disintegrating tablets contain aspartame that forms phenylalanine.

• Mirtazapine may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, or swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

Unless your medical provider tells you otherwise, continue your normal diet.

Stopping mirtazapine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, dizziness, vomiting, nightmares, headache and/or a tingling sensation on the skin.⁵

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community.

In case of overdose, call the poison control helpline at 1-800-222-1222 or dial 911.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all the prescription and nonprescription (over the counter) medicines you are taking, as well as any products such as vitamins, minerals or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names for mirtazapine is Remeron® and Remeron SolTab.⁶

1. Sleep Foundation

2. NAMI

3. NAMI

4. Mayo Clinic

5. NAMI

6. NAMI

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