Felis ISSN 2398-2950

Mirtazapine

Synonym(s): Remeron®, Mirataz®, Zispin

Contributor(s): Vetstream Ltd, Marge Chandler

Introduction

Name

  • Mirtazapine.

Class of drug

  • Tetracyclic antidepressant.

Description

Chemical name

  • 1,2,3,4,10,14b-hexahydro-2-methylpyrazino [2,1-a] pyrido [2,3-c] benzazepine

Molecular formula

  • C17H19N3

Molecular weight

  • 265.36

Physical properties

  • White to creamy white crystalline powder.
  • Available as 15, 30 and 45 mg tablets (oral distintegrating) and 7.5, 15 and 30 mg tablets (scored film-coated).
  • Available as transdermal ointment.

Storage requirements

  • The coated tablets and the orally disintegrating tablets should be stored at 25°C (77ºF) with excursions permitted to 15-30°C (59-86°F). 
  • Protect from light and moisture.
  • The stability of the orally disintegrating tablets once removed from the tablet blister is unknown and immediate use is recommended.

Uses

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Indications

  • Appetite stimulant and anti-nausea drug.

Administration

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Pharmocokinetics

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Precautions

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Interactions

With other drugs

  • Clonidine Clonidine: mirtazapine may cause increases in blood pressure.
  • Cyproheptadine Cyproheptadine: may negate the effects of mirtazapine.
  • Diazepam Diazepam (and other benzodiazepines): minimal effects on mirtazapine blood levels, but may cause additive impairment of motor skills.
  • Fluvoxamine: may cause increased serum concentrations of mirtazapine.
  • Linezolid: increased risk for serotonin syndrome.
  • Selegiline Selegiline, Amitraz Amitraz: increased risk for serotonin syndrome; MAO inhibitors considered contraindicated with mirtazapine.
  •  Tramadol Tramadol: increased risk for serotonin syndrome.

Adverse Reactions

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed Papers

  • Recent references from VetMed Resource and PubMed.
  • Buhles W, Quimby J M, Labelle D et al (2018) Single and multiple dose pharmacokinetics of a novel transdermal ointment in cats. J Vet Pharmacol Ther In press.
  • Benson K K, Zajic L B, Morgan P K et al (2017) Drug exposure and clinical effect of transdermal mirtazapine in healthy young cats: a pilot study. J Feline Med Surg 19(10), 998-1006 PubMed.
  • Ferguson L E, McLean M K, Bates J A, Quimby J M (2016) Mirtazapine toxicity in cats: retrospective study of 84 cases (2006-2011). J Feline Med Surg 8(11), 868-874 PubMed.
  • Agnew W, Korman R (2014) Pharmacological appetite stimulation: rational choices in the inappetent cat. J Feline Med Surg 16(9), 749-756 PubMed.
  • Quimby  J M, Lunn K F (2013) Mirtazapine as an appetite stimulant and anti-emetic in cats with chronic kidney disease: a masked placebo-controlled crossover clinical trial. Vet J 197(3), 651-655 PubMed
  • Quimby J M, Gustafson D L, Lunn K F (2011) The pharmacokinetics of mirtazapine in cats with chronic kidney disease and in age-matched control cats. JVIM 25(5), 985-959 PubMed

Other sources of information


ADDED