Depression Home > Remeron Warnings and Precautions
An awareness of Remeron warnings and precautions before taking it can ensure a safe treatment process. For example, the drug carries an increased risk of suicidal thoughts and the possibility of seizures. Prior to taking Remeron, tell your healthcare provider if you have bipolar disorder or have liver or kidney problems. Remeron warnings and precautions also extend to people who are allergic to any ingredients used to make the medication.
Remeron: What Should I Tell My Healthcare Provider?You should talk to your healthcare provider prior to taking Remeron® (mirtazapine) if you have:
- Bipolar disorder or a family history of bipolar disorder (also known as manic depression)
- A history of heart attack or stroke
- Chest pain
- A low level of white blood cells (neutropenia)
- Liver problems, including liver failure or cirrhosis
- Kidney disease, including kidney failure (renal failure)
- Seizures or epilepsy
- Low blood pressure (hypotension)
- A history of suicide attempts or suicidal thoughts
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Be sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Specific Remeron Warnings and PrecautionsSome warnings and precautions to be aware of prior to taking Remeron include the following:
- Antidepressants (including Remeron) may increase the risk of suicidal thoughts or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or develop any new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include:
- Extreme hyperactivity
- Suicidal thoughts or behavior (see Remeron and Suicide for more information).
- Taking Remeron with other medications that affect serotonin can increase your risk of a dangerous group of symptoms called serotonin syndrome. These other medications include other antidepressants, triptans (migraine medications), and a few other medications (see Remeron Drug Interactions for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:
- Before prescribing Remeron for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes, the symptoms of bipolar disorder and depression can be similar, and Remeron can cause problems in people with bipolar disorder.
- There have been reports of Remeron causing very low levels of white blood cells (which may increase your risk of infections). Because of this, let your healthcare provider know if you have signs of an infection, such as a sore throat or fever.
- Remeron often causes drowsiness and dizziness. Because of this, the drug may affect your ability to perform complex tasks requiring mental and motor skills. Taking it with alcohol or other medications that cause drowsiness can increase this effect. Therefore, you should become accustomed to Remeron's effect on you before becoming involved in activities requiring mental or motor concentration (such as driving a car or operating machinery).
- In studies, Remeron caused an increase in appetite and weight gain (see Remeron and Weight Gain). Talk to your healthcare provider if you are noticing weight gain while taking Remeron.
- Remeron can cause high cholesterol and high triglycerides. Your healthcare provider may want to monitor your cholesterol and triglyceride levels while you are taking the drug.
- In rare cases, Remeron has been reported to cause low blood sodium levels (hyponatremia). The risk for this electrolyte imbalance is probably greatest for elderly individuals.
- Remeron is known to cause increased liver enzymes (found using a blood test). This may be a sign of liver damage. The medication should be used with caution in people with known liver problems.
- In rare cases, seizures have been reported in people taking Remeron. Talk to your healthcare provider before taking the medication if you have a seizure disorder.
- Sometimes, Remeron can cause low blood pressure, which can be dangerous in people who have had a heart attack, stroke, or chest pain. Let your healthcare provider know if you experience symptoms of low blood pressure, such as lightheadedness, dizziness, or fainting.
- Because the kidneys help remove Remeron from the body, you may need a lower Remeron dosage if you have kidney problems.
- Orally disintegrating Remeron tablets (Remeron SolTabs®) contain phenylalanine. This is important for people with phenylketonuria, who must limit their phenylalanine intake.
- Remeron can interact with certain medications (see Remeron Drug Interactions).
- Remeron is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug during pregnancy (see Mirtazapine and Pregnancy for more information).
- It is not known if Remeron passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider before using Remeron (see Remeron and Breastfeeding).