Mirtazapine, Mirtazapine Odt

Mirtazapine (mir TAZ a peen) is a generic medication prescribed for depression in adults. Mirtazapine belongs to a group of drugs called antidepressants.

Medically reviewed by Patricia Weiser, PharmD on May 11, 2023
Written by Sarah Lewis, PharmD

This article describes mirtazapine’s uses, side effects, and more. Below you’ll also find some coupon options to help save on the cost of mirtazapine.

Mirtazapine comes as an oral tablet that you swallow and an orally disintegrating tablet (ODT) that dissolves in your mouth. This article doesn’t provide coupons for all forms of mirtazapine. To find out more about mirtazapine ODT, see this article.

Boxed warning: Risk of suicidal thoughts and behaviors

Mirtazapine has a boxed warning about the risk of suicidal thoughts and behaviors in people ages 24 years and younger. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for mirtazapine” section below.

Side effects of mirtazapine

Mirtazapine may cause mild or serious side effects. More common mild side effects of mirtazapine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about mirtazapine’s side effects, see this article or ask your doctor or pharmacist. You can also read the prescribing information* for mirtazapine.

* To view mirtazapine’s prescribing information, see the “Article resources” section below.

Mild side effects

More common mild side effects reported with mirtazapine are listed below. This article doesn’t include all possible mild side effects of the drug.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mirtazapine’s mild side effects include:

• dizziness
• increased appetite
• sleepiness
• weight gain
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for mirtazapine” section below.

Serious side effects

Serious side effects of mirtazapine are listed below. This article doesn’t include all possible serious side effects of the drug.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, mirtazapine’s serious side effects include:

• mania (episodes of very high energy)
• discontinuation syndrome (side effects that can happen when you stop mirtazapine, especially when you stop it suddenly)
• high levels of cholesterol and triglycerides (certain kinds of fats in your bloodstream)
• increased liver enzyme levels, which can be a sign of liver problems
• low sodium (salt) level
• long QT syndrome (changes in the heart’s electrical signals, which can lead to serious and life threatening heart rhythm problems)
• seizures
• serotonin syndrome (too much of the chemical serotonin, which can be life threatening)
• severely low levels of white blood cells, which results in reduced immune system activity
• boxed warning: risk of suicidal thoughts and behaviors in young adults*
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for mirtazapine” section below.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Common questions about mirtazapine

Below you’ll find answers to a few commonly asked questions about mirtazapine.

Can mirtazapine be used for sleep or anxiety?

Possibly. Mirtazapine isn’t approved for sleep problems or anxiety. But doctors may choose to prescribe it for these purposes, especially if you have depression. It’s called an off-label use when doctors prescribe a drug for a condition other than its approved uses. Mirtazapine is approved for depression treatment.

It’s important to note that mirtazapine can cause sleepiness as a side effect, so doctors usually recommend taking it at bedtime.

Talk with your doctor if you’d like to learn more about taking mirtazapine for sleep or anxiety. 

What brand names are available for mirtazapine?

Mirtazapine oral tablet is available as the brand-name drug Remeron. The mirtazapine orally disintegrating tablet is available as the brand-name drug Remeron SolTab.

If you’re interested in the brand-name versions of mirtazapine, talk with your doctor or pharmacist.

Is mirtazapine safe for older adults?

Yes, but there are precautions for older adults (ages 65 years and over) taking mirtazapine.

In older adults, sleepiness caused by mirtazapine can lead to confusion and being overly sleepy. Older adults also tend to have reduced kidney function and other changes in organ function. This can lead to a higher level of mirtazapine in the body and other problems.

Due to these risks, doctors usually start with a low dose of mirtazapine in older adults.

If you’re concerned about taking mirtazapine because of your age, talk with your doctor or pharmacist.

Does mirtazapine cause withdrawal symptoms?

Yes, mirtazapine can cause withdrawal symptoms, also called discontinuation syndrome. These are symptoms that can occur if you stop taking a drug your body has become dependent on. Suddenly stopping the drug increases the risk of these symptoms.

Withdrawal symptoms can include:

• abnormal dreams
• anxiety or agitation
• dizziness
• electric shock sensations or other strange feelings
• fatigue (low energy)
• headache
• nausea and vomiting
• sweating
• shaking you can’t control

Do not stop taking mirtazapine without talking with your doctor. They can answer any questions about stopping the drug and how to do it safely.

How does mirtazapine work? And how long does it take to start working?

Mirtazapine is thought to work by balancing chemical messengers in the brain. These chemical messengers are called neurotransmitters. The ones that mirtazapine affects likely play a role in your mood. Balancing them can help to treat depression.

When you start mirtazapine, some of your symptoms may ease within 1–2 weeks. Like other antidepressants, it can take several weeks to feel the full effect of mirtazapine.

Talk with your doctor or pharmacist to find out more about what to expect with mirtazapine.

Is mirtazapine similar to trazodone?

Yes, mirtazapine and trazodone are similar. They’re both antidepressants that affect similar chemical messengers in the brain. Their side effects and warnings are also similar. But the drugs do have some differences, such as their dosing.

If you have questions about trazodone and how it compares with mirtazapine, talk with your doctor or pharmacist.

Interactions and warnings for mirtazapine

Below, you’ll find information about mirtazapine’s possible interactions and warnings.

Interactions of mirtazapine

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take mirtazapine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription drugs
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for mirtazapine” section just below.

Warnings for mirtazapine

Some people should not take mirtazapine, and others should take it cautiously.

Boxed warning: Risk of suicidal thoughts and behaviors

Mirtazapine has a boxed warning about the risk of suicidal thoughts and behaviors in certain people. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

With antidepressants such as mirtazapine, there is an increased risk of suicidal thoughts and actions in children, teenagers, and young adults (ages 24 years and younger). The risk is highest during the first few months of treatment and during dosage changes.

Keep in mind that depression can also cause suicidal thoughts and behaviors. Doctors prescribe mirtazapine for depression.

Due to this risk, mirtazapine is not approved for use in people younger than age 18 years. Your doctor will monitor for any new changes in your mood, behavior, thoughts, or feelings during mirtazapine treatment. Your doctor will also ask your family or caregivers to watch for these signs.

To learn more, talk with your doctor or pharmacist.

Other warnings

Mirtazapine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether mirtazapine is a safe option for you.

Ask your doctor about specific warnings for mirtazapine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Mirtazapine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to mirtazapine or any of its ingredients, your doctor will likely not prescribe mirtazapine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• severe skin rashes that may blister and peel
• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to mirtazapine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and mirtazapine

Information about mirtazapine, pregnancy, and breastfeeding is described below.

Mirtazapine and pregnancy

It’s not known whether mirtazapine should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

If you take mirtazapine during pregnancy, you could consider joining the drug’s pregnancy registry. Pregnancy registries help gather information about how certain drugs affect pregnancy. To learn more or sign up, you can call 866-961-2388 or visit the registry website. You can also talk with your doctor.

Mirtazapine and breastfeeding

It’s not known whether mirtazapine should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

Uses of mirtazapine

The Food and Drug Administration (FDA) approves prescription drugs such as mirtazapine for certain conditions. Mirtazapine’s approved use is described below.

Use for depression

Doctors may prescribe mirtazapine for treating depression. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With depression, you have changes in the way you feel, think, and act. Symptoms can include:

• feelings of hopelessness, sadness, or worthlessness
• increased sleeping or other sleep problems
• lack of energy
• loss of interest in activities
• low appetite

Doctors may not prescribe mirtazapine in certain situations, such as for people who also take monoamine oxidase inhibitor drugs.

Dosage of mirtazapine

The dosage of mirtazapine your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should follow.

Taking mirtazapine

You should swallow mirtazapine oral tablet. Mirtazapine oral disintegrating tablet is taken by putting it on your tongue and letting it dissolve.

Take mirtazapine once a day, preferably in the evening or at bedtime. Both forms of mirtazapine can be taken with or without food.

Your doctor will talk with you about how to take mirtazapine. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

Overdose of mirtazapine

You should not take more mirtazapine than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much mirtazapine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Mirtazapine coupon

You may be able to save money on your prescription for mirtazapine by using our Perks discount coupons. They can be found at the end of this article.

If you have questions about how to pay for mirtazapine, talk with your doctor or pharmacist. You can also learn more about the cost of mirtazapine in this article.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

What to ask your doctor

This article describes mirtazapine’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about mirtazapine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Can mirtazapine cause sexual side effects?
• What is the best time of day to take mirtazapine?
• Is mirtazapine safe for me, given my other medical conditions and medications?

 Article resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Mirtazapine- mirtazapine tablet, orally disintegrating. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/5127517f-b8d0-4af1-8a2f-5225719600bc/spl-doc
• Mirtazapine – mirtazapine tablet, film coated. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/67e753ad-9919-416b-9e8f-aab0fa808066/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.