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Remeron

Remeron
Remeron is a tetracyclic antidepressant that is used for treating symptoms associated with depression.

Brand: Mirtazapine

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: May 2024
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Remeron 30 mg
270 pills - 30 mg
+ 12 free Viagra 100 mg, 7% discount for future orders
$543.95 $2.01 $317.80 Add to cart
180 pills - 30 mg
+ 12 free Viagra 100 mg, 7% discount for future orders
$373.97 $2.08 $200.53 Add to cart
120 pills - 30 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$262.91 $2.19 $120.09 Add to cart
90 pills - 30 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$207.93 $2.31 $79.32 Add to cart
60 pills - 30 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$151.98 $2.53 $39.52 Add to cart
30 pills - 30 mg $95.75 $3.19 No Add to cart
Remeron 15 mg
360 pills - 15 mg
+ 12 free Viagra 100 mg, 7% discount for future orders
$381.99 $1.06 $206.61 Add to cart
270 pills - 15 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$293.93 $1.09 $147.52 Add to cart
180 pills - 15 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$198.99 $1.11 $95.31 Add to cart
120 pills - 15 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$136.95 $1.14 $59.25 Add to cart
90 pills - 15 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$112.93 $1.25 $34.22 Add to cart
60 pills - 15 mg $81.99 $1.37 $16.11 Add to cart
30 pills - 15 mg $49.05 $1.64 No Add to cart

Product description

Drug Title

Remeron (Mirtazapine)

Pharmacological action

The drug Remeron (mirtazapine) is a tetracyclic antidepressant with predominantly sedative action. The drug is most effective in depressive states with symptoms such as inability to experience pleasure and joy, loss of interest (anhedonia), psychomotor retardation, sleep disturbances (especially in form of early awakening) and weight loss, as well as other symptoms: suicidal ideation and daily mood swings.


The antidepressant effect of Remeron usually occurs after 1-2 weeks of treatment.


Mirtazapine is an antagonist of presynaptic α2-adrenoreceptors in the central nervous system and increases central noradrenergic and serotonergic nerve impulse transmission. The enhancement of serotonergic transmission is realized only through serotonin 5-HT1 receptors, because mirtazapine blocks serotonin 5-HT2- and 5-HT3-receptors. Both enantiomers of mirtazapine are thought to have antidepressant activity, the S(+) enantiomer by blocking α2-adreno- and serotonin 5-NT2-receptors and the R(-) enantiomer by blocking serotonin 5-NT3-receptors.


The sedative properties of mirtazapine are due to its antagonistic activity toward H1-histamine receptors.


Mirtazapine is generally well tolerated. At therapeutic doses, it has almost no m-cholin-blocking effect and has almost no effect on the cardiovascular system.


Pharmacokinetics

After oral administration, mirtazapine is rapidly absorbed (bioavailability about 50%), reaching Cmax in plasma after about 2 hours. About 85% of mirtazapine is bound to plasma proteins. The average T1/2 is 20 to 40 h (rarely up to 65 h). A shorter T1/2 is observed in young people. The equilibrium concentration of the substance is reached after 3-4 days and does not change thereafter. In the recommended dose range, the pharmacokinetic parameters of mirtazapine have a linear dependence on the administered dose of the drug. Food intake has no effect on the pharmacokinetics of the drug.


Mirtazapine is actively metabolized and excreted in the urine and feces within a few days. Its main pathways of metabolism in the body are demethylation and oxidation followed by conjugation. Cytochrome P450 isoenzymes (CYP2D6 and CYP1A2) are involved in the formation of the 8-hydroxy metabolite of mirtazapine, while CYP3A4 presumably determines the formation of N-demethylated and N-oxidized metabolites. Demethylmirtazapine is pharmacologically active.


Clearance of mirtazapine is decreased in renal or hepatic impairment.


Contraindications to use

  • Hypersensitivity to mirtazapine or any of the excipients.

Patients with such rare hereditary problems as lactose intolerance, lactase deficiency or glucose-galactose malabsorption should not be prescribed Remeron.


Since the safety and efficacy of Remeron in children under 18 years of age has not been established, it is not recommended to use Remeron for children.


Caution


Correction in dosage regimen and regular medical monitoring are necessary for the following patients:


  • Patients with epilepsy and organic brain lesions (against the background of therapy with Remeron in rare cases, seizures may develop);
  • Patients with hepatic or renal insufficiency;
  • Patients with heart disease (conduction disorders, angina pectoris, or recent myocardial infarction);
  • Patients with cerebrovascular disease (including a history of ischemic stroke);
  • Patients with arterial hypotension and with conditions that predispose to hypotension (including dehydration and hypovolemia);

           - patients who abuse drugs, with dependence on drugs affecting CNS, with mania, hypomania.

Like other antidepressants, Remeron should be used with caution in the following cases:


  • urinary disorders, including prostatic hyperplasia;
  • acute closed-angle glaucoma and elevated intraocular pressure;
  • diabetes mellitus;
  • concomitant administration of benzodiazepines with Remeron.

Use in pregnancy and lactation

The safety of using Remeron during pregnancy in humans has not been established; however, no teratogenic effect has been detected in animals, therefore, it may be used during pregnancy only when the benefit to the mother exceeds the potential risk to the fetus.


The use of Remeron during lactation is not recommended because of the lack of data on its excretion with the breast milk in humans.


Administration in liver dysfunction

Use with caution in patients with hepatic insufficiency.


In patients with hepatic impairment, the clearance of mirtazapine may be decreased. This should be taken into account when prescribing Remeron in these patients.


Administration in patients with renal dysfunction

Use with caution in patients with renal insufficiency.


Mirtazapine clearance may be decreased in patients with renal impairment. This should be taken into account when prescribing Remeron in these patients.


Administration in children

Since the safety and efficacy of Remeron in children under 18 years of age has not been established, it is not recommended to use Remeron for children.

Indications for the drug Remeron

depression.

Dosing regimen

The tablets should be taken orally, with fluids if necessary, and swallowed without chewing.


Adults: The effective daily dose is usually between 15 and 45 mg; the starting dose is 15 or 30 mg.


Elderly: The recommended dose is the same as for adults. In elderly patients, in order to achieve a satisfactory and safe response to treatment, dose increases should be made under the direct supervision of a physician.


In patients with renal or hepatic impairment, the clearance of mirtazapine may be reduced. This should be considered when prescribing Remeron in these patients.


Remeron may be taken once a day, preferably at the same time, before bedtime. Remeron may also be administered twice a day, dividing the daily dose in half (once in the morning and once at night, the higher dose should be taken at night).


Treatment should be continued if possible for 4-6 months until the complete disappearance of symptoms in the patient. After that, treatment may be gradually withdrawn. Mirtazapine usually takes effect after 1 to 2 weeks of treatment. Treatment with an adequate dose should lead to a positive response after 2-4 weeks. If there is an insufficient response to treatment, the dose may be increased to the maximum dose (up to 45 mg). If there is no response to treatment after another 2-4 weeks, treatment should be discontinued.