Remeron

Ремерон Drug photo

The description is actual on 05.05.2015

  • Latin name: Remeron
  • ATH code: N06AX11
  • Active ingredient: Mirtazapin (Mirtazapine)
  • Producer: LLC MSD Farmasyyutikalz, Russia

Structure

Remeron is a part of one tablet 15, 30 or 45 mg of active ingredient of a mirtazapin + auxiliary elements (corn starch, magnesium stearate, monohydrate of lactose, a gipromelloz, titanium dioxide, yellow iron oxide, hydroxypropyl cellulose, silicon dioxide anhydrous colloid, polyethyleneglycol 8000, red iron oxide).

Release form

Drug let out in the form of oval biconvex tablets, on one party marking of "Organon", on other party a code.

Color: red-brown, tablets from risky. In blisters, packagings from a cardboard there are 10 or 30 pieces.

Pharmacological action

Antidepressive.

Pharmacodynamics and pharmacokinetics

Mirtazapin is the antagonist presynaptic alpha 2 - receptors, stimulates the central noradrenalinovy and serotoninergichny transfer of nervous impulses. Substance blocks 5-HT2 and can only pass 5-HT3-receptors and an impulse through 5-HT1. Drug possesses sedation, does not influence cardiovascular activity.

After reception of tablets medicine is well and quickly soaked up and gets into a system blood stream, its biological availability reaches 50%. The maximum concentration is observed in 2 hours. Active ingredient well contacts proteins of a blood plasma. It is brought out of an organism from 20 to 40 hours (to 65). Medicine reaches equilibrium concentration in 4 days, then mirtazapin does not collect in an organism any more. Meal does not influence pharmacokinetic parameters of means in any way.

Process of a conclusion of drug happens to a stake and urine within several days. Reactions of a metabolism proceed with participation of CYP2D6 and CYP1A2 enzymes of P450 cytochrome.

At diseases of a liver or kidneys the clearance of a mirtazapin decreases.

Indications to use

By means of drug treat a deep depression.

Contraindications

Means is contraindicated in the presence of reactions of hypersensitivity to its components. Tablets cannot be combined with MAO inhibitors.

Side effects

It is difficult to divide the symptoms of a depression and side effects which arose from treatment by drug.

Most often during treatment by Remeron were observed: drowsiness, dryness in a mouth, increase in weight, appetite increase, a headache, fatigue, a sedatation and dizziness. Were less often revealed: sleeplessness, a tremor, confusion of consciousness, a lethargy, a mialgiya, decrease in the ABP, nausea, vomiting, a diarrhea, an arthralgia, dorsodynias, hypostases on the periphery, increased fatigue, pseudo a rubella.

Seldom and very seldom can be shown:

  • nightmares, hallucinations and manias, hyponatremia, agranulocytosis;
  • excessive psychomotor excitement, aplastic anemia, paresthesia, myoclonia;
  • thrombocytopenia, tendency to a suicide, agitation, serotoninovy syndrome;
  • hypostases on mucous a mouth, increase of activity of enzymes of a liver;
  • violent dermatitis, erythema, Stephens-Johnson's syndrome;
  • toxic epidermal necrolysis, disturbance of hormonal balance (antidiuretic hormone).

Application instruction of Remeron (way and dosage)

Orally, washing down with water. Tablets do not get to the core and do not divide.

Drug is drunk once a day. It is desirable to take medicine of one times a day, for the night, before withdrawal to a dream.

Also if necessary the dosage can be divided into two receptions. And to accept the most part in the evening.

On the end of therapy it is necessary to lower gradually a drug dosage to avoid development of a withdrawal.

Dosing mode

Adult, as a rule, appoint from 15 to 45 mg of medicine. The initial dosage makes 15 or 30 mg. Efficiency of drug reaches the maximum in 7-14 days after the beginning of therapy. If necessary the dosage can be increased.

If within a month positive changes did not come, then medicine needs to be replaced.

Correction of a dosage is not required to elderly people. However process of increase of a dose has to happen under supervision of the doctor.

At a renal failure it is recommended to make control of KK regularly.

At serious diseases of a liver treatment of drug needs to be carried out under supervision of the specialist.

Overdose

Usually at overdose Remedon symptoms of easy severity arise drug: a disorientation, a sedatation, tachycardia, hypo - or hypertensia, oppression of functions of the central nervous system. If overdose happened several drugs at the same time, then symptoms can be much more serious, up to a lethal outcome.

Therapy – symptomatic, supporting, reception of Absorbent carbon, a gastric lavage.

Interaction

Medicine strengthens the oppressing TsNS effect of benzodiazepines, sedative drugs, antipsychotic, antihistamines, opioids.

Mirtazapin it is impossible to combine with MAO inhibitors. The break between rates of drugs has to make not less than 2 weeks. Besides, the concomitant use with selective serotonin reuptake inhibitors, Triptane, Tramadol, L-tryptophane, Venlafaksin, a St. John's Wort and lithium, can increase the frequency and expressiveness of side effects.

With care it is necessary to combine means with Ketokonazol, Cimetidinum, azolny antifungal means, Erythromycin, Nefazodon.

These drugs cannot take alcohol during treatment.

At treatment Warfarin and Remeron recommend to control PTI as such combination raises an indicator of coagulability of blood.

Phenytoinum and Carbamazepine, CYP3A4 enzyme inductors, increase Mirtazapin's clearance. Therefore its concentration decreases approximately in a half. At a drug combination to any inductors of enzymes of a liver it is necessary to adjust a medicine dosage.

Terms of sale

Medicine is on sale according to the recipe.

Storage conditions

It is recommended to store tablets in the dry, cool place, at a temperature not lower than 2 degrees, and not higher than 30.

To protect medicine for children.

Period of validity

3 years.

Special instructions

The risk of development of an agranulocytosis considerably increases at persons 65 years are more senior. As a rule, the granulocytopenia and the agranulocytosis arising in the course of treatment has reversible character, but also cases of a lethal outcome were registered. In general, dependence of frequency of manifestation of side reactions on age of the patient was not observed.

Medicine contains lactose. Therefore persons with intolerance of a galactose, a lactose intolerance, disturbances of processes of absorption of glucose galactose cannot accept this drug.

In an initiation of treatment the risk of development of suicide behavior can increase. Improvements in a condition of the patient come after several weeks of systematic drug intake. Patients who tried to commit suicide earlier, and persons with the expressed suicide thoughts and bents have to be under supervision. In view of thirst for suicide at the initial stages of treatment, the patient has to accept the minimum dosage of drug the first several weeks.

If the patient got sick with jaundice, then reception of tablets it is necessary to stop and ask immediately for the help the doctor.

At a drug combination to serotoninergichny means the serotoninovy syndrome can develop. Its symptoms: hyperthermia, myoclonia, muscle tension, fluctuations of the vital indicators, confusion of consciousness, excitement, annoyance. When carrying out monotherapy the syndrome develops extremely seldom.

With care and in the minimum dosage medicine is appointed:

Drug intake can strengthen psychotic symptoms of schizophrenia and paranoid thoughts.

At the sharp termination of therapy means (especially in high doses) seldom observed a withdrawal: excitement, headache, dizziness, nausea. Eventually symptoms pass in itself.

Remeron's analogs

The closest analogs of drug: Alventa, Velaksin, Venlaksor, Venlift, Gelarium Giperikum, Depreksor, Deprivit, Intriv, Koaksil, Medofaksin, Mianserin, Neyroplant, Pyrazidolum, Trittico, Prefaksin, Negrustin, Valdoksan, Azaphenum, Normazidol, Venlafaksin, Simbalta, Miaser, Melitor, Lerivon, Intriv, Deprim, Depresil, Velbutrin, Brintelliks.

Zdravzona

  • Remeron of 30 mg No. 30 of a tablet
  • Remeron of 30 mg No. 10 of a tablet

Drugstore of IFC

  • Remeron tbl 30 mg No. 10, Organonniderlandy
  • Remeron tbl 30 mg No. 30, Organonniderlandy
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Section: For a nervous system
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