Remeron Warnings and Precautions

Remeron (Mirtazapine)

Specific Remeron Warnings and Precautions

Some 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:

Anxiety
Hostility
Agitation
Panic
Restlessness
Hallucinations
Extreme hyperactivity

Suicidal thoughts or behavior (see Remeron and Suicide for more information).

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.
Taking Remeron with monoamine oxidase inhibitors (MAOIs) can lead to dangerous side effects. You should not take Remeron if you have taken an MAOI within the past two weeks.
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.
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).

(Remeron Warnings and Precautions Continued: Page 3)
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