SEPTILIN Price

Overview

Welcome to Dwaey, specifically on SEPTILIN page.
This medicine contains an important and useful components, as it consists of
Balsamodendron mukul (Guggulu purified powder), Emblica officinalis (Indian Gooseberry ext.), Glycyrrhiza glabra (Licorice ext.), Maharasnadi quath (Ayurvedic composite conatins mainly Vada roxburghii), Rubia cordifolia (Indian Madder ext.), Saussurea cosis available in the market in concentration

Name

Mirtazapine

Precaution

Before using **Mirtazapine**, it is essential to consult with a healthcare provider to determine its appropriateness for the individual. Key precautions include: - **Suicidal Thoughts**: As with other **antidepressants**, **Mirtazapine** may increase the risk of suicidal thoughts or behavior, especially in young adults and adolescents. Close monitoring is required during the initial treatment phase and when adjusting the dosage. - **History of Bipolar Disorder**: **Mirtazapine** should be used cautiously in individuals with a history of **bipolar disorder** due to the potential of precipitating a **manic episode**. It is essential to rule out bipolar disorder before starting treatment for depression. - **Liver and Renal Impairment**: **Mirtazapine** should be used with caution in patients with liver or kidney impairment. Dose adjustments may be required, and regular monitoring of liver function is advised. - **Allergic Reactions**: Severe allergic reactions, such as **rash**, **swelling**, and **difficulty breathing**, may occur in rare instances. If any signs of an allergic reaction appear, **Mirtazapine** should be discontinued immediately, and medical help should be sought. - **Discontinuation Syndrome**: Abrupt discontinuation of **Mirtazapine** can lead to withdrawal symptoms like dizziness, nausea, headache, and irritability. It is important to taper the dose gradually under medical supervision.

Indication

**Mirtazapine** is primarily used for the treatment of: - **Major Depressive Disorder (MDD)**: **Mirtazapine** is most commonly prescribed for the treatment of **major depressive disorder**. It helps alleviate symptoms such as persistent sadness, loss of interest in daily activities, fatigue, and difficulty concentrating. - **Anxiety**: **Mirtazapine** is sometimes used off-label to treat **generalized anxiety disorder (GAD)** and **social anxiety disorder** due to its calming effects. - **Insomnia**: Due to its sedative properties, **Mirtazapine** is sometimes used off-label for patients with **insomnia**. The medication’s ability to promote sleep can be beneficial for patients with depression-related sleep disturbances. - **Appetite Stimulation**: **Mirtazapine** may also be prescribed to help increase **appetite** in patients with conditions such as cancer, **HIV/AIDS**, or eating disorders.

Contra indication

**Mirtazapine** should not be used in certain circumstances: - **Hypersensitivity**: **Mirtazapine** is contraindicated in individuals with a known **allergy** to the drug or any of its components. An allergic reaction may result in symptoms such as rash, itching, or difficulty breathing. - **Monoamine Oxidase Inhibitors (MAOIs)**: **Mirtazapine** should not be taken concurrently with **MAOIs** or within 14 days of discontinuing an MAOI due to the risk of **serotonin syndrome**, a potentially life-threatening condition. - **Pregnancy and Breastfeeding**: While **Mirtazapine** is categorized as a **Category C** drug during pregnancy (which means the risk cannot be ruled out), it should only be used during pregnancy if the benefits outweigh the risks. It should be used with caution in breastfeeding mothers as well, as it may pass into breast milk. - **Pheochromocytoma**: **Mirtazapine** should be avoided in patients with **pheochromocytoma**, a rare tumor of the adrenal gland that may affect the body's ability to regulate blood pressure.

Side Effect

Common and severe side effects of **Mirtazapine** should be monitored: - **Common Side Effects**: - **Sedation** and **drowsiness** are frequent, particularly when starting treatment or when the dose is increased. This can make it useful for individuals with sleep disturbances. - **Weight Gain** and **increased appetite**: These effects are relatively common and may lead to significant weight gain over time. - **Dry Mouth**, **constipation**, and **dizziness** can also occur, especially during the initial stages of treatment. - **Tremors** or mild **muscle stiffness** may also be observed. - **Severe Side Effects**: - **Serotonin Syndrome**: This rare but serious condition can occur, especially when **Mirtazapine** is combined with other serotonergic drugs. Symptoms include confusion, agitation, hyperreflexia, tremor, and high fever. - **Severe Allergic Reactions**: Signs include difficulty breathing, swelling of the face, lips, or throat, and a rash. - **Neutropenia or Agranulocytosis**: Rarely, **Mirtazapine** can cause a reduction in white blood cell count, leading to **neutropenia** or **agranulocytosis**, which can increase the risk of infections. - **Severe Weight Gain or Edema**: In some patients, the weight gain can be significant, and they may experience **fluid retention** (edema), particularly in the legs or ankles.

Pregnancy Category ID

3

Mode of Action

**Mirtazapine** is a **tetracyclic antidepressant** that works by affecting various neurotransmitter systems in the brain: - **Alpha-2 Adrenergic Receptor Antagonism**: **Mirtazapine** blocks **alpha-2 adrenergic receptors**, which normally inhibit the release of neurotransmitters. By blocking these receptors, **Mirtazapine** increases the release of **norepinephrine** and **serotonin**, two neurotransmitters involved in mood regulation and cognition. - **5-HT2 and 5-HT3 Receptor Antagonism**: **Mirtazapine** also blocks specific serotonin receptors (**5-HT2** and **5-HT3**), which helps enhance serotonin's effects on mood without producing some of the side effects (e.g., nausea) associated with other antidepressants. - **Histamine Receptor Antagonism**: The **histamine** receptor antagonism is responsible for **Mirtazapine’s** sedative effects, which may help patients with insomnia or anxiety associated with depression.

Interaction

Several drugs and substances may interact with **Mirtazapine**: - **Serotonergic Drugs**: When combined with other serotonergic drugs (such as **SSRIs**, **SNRIs**, **triptans**, or **tricyclic antidepressants**), **Mirtazapine** increases the risk of **serotonin syndrome**, which can cause symptoms such as agitation, fever, sweating, and confusion. - **CNS Depressants**: **Mirtazapine** can potentiate the effects of **central nervous system depressants** like alcohol, **benzodiazepines**, or **opioids**. This combination may lead to excessive sedation, respiratory depression, and impaired motor coordination. - **Antihypertensive Drugs**: **Mirtazapine** may interact with **antihypertensive medications** (such as **ACE inhibitors** or **beta-blockers**) and increase the risk of **hypotension**. - **CYP450 Enzyme Inhibitors/Inducers**: **Mirtazapine** is metabolized by the liver enzyme **CYP2D6**. Medications that inhibit or induce this enzyme (e.g., **fluoxetine**, **rifampin**) may alter the blood levels of **Mirtazapine** and affect its efficacy or risk of side effects.

Pregnancy Category Note

Information not available

Adult Dose

For adults, the typical starting dose of **Mirtazapine** for **major depressive disorder** is: - **Initial Dose**: Typically **15 mg** once daily, usually taken in the evening due to its sedative effects. - **Dose Adjustment**: The dose can be gradually increased to **30 mg** or **45 mg** once daily depending on patient response and tolerance. The maximum dose is generally **45 mg/day**. - It is important to take **Mirtazapine** at the same time each day to help establish a routine and improve effectiveness.

Child Dose

**Mirtazapine** is not typically approved for use in pediatric populations for the treatment of **major depressive disorder**. There is limited data on its safety and efficacy in children and adolescents. The prescribing of **Mirtazapine** to minors should be considered carefully, and the dosage would need to be determined by a healthcare provider based on individual clinical judgment. As always, it is crucial for patients to consult their healthcare provider before beginning **Mirtazapine** treatment to ensure it is safe and appropriate for their condition.

Renal Dose

For patients with **renal impairment**: - **Mild to Moderate Renal Impairment**: No significant dose adjustment is typically required. - **Severe Renal Impairment**: The use of **Mirtazapine** in patients with severe renal impairment (e.g., creatinine clearance < 30 mL/min) should be approached with caution. The healthcare provider may opt for a lower starting dose or increased monitoring to reduce the risk of side effects due to potential accumulation.

Administration

Information not available