中文正式名：米氮平
商品名及别名：瑞美隆（Remeron）
英文名：mirtazapine
化学名：1，2，3，4，10，14b六氢一2一甲基吡嗪基[2，1-a]吡啶并［2，3-C］氮卓
性状：“米氮平-瑞美隆” 片剂为两面凸起的椭圆形，其中一面有“Organon”字样，另一面有代码。15毫克和30毫克片剂上有刻痕。
药理学特征：瑞美隆（米氮平）是抗抑郁药，适用于抑郁症。对症状如快感缺乏，精神运动性抑制，睡眠欠佳（早醒）以及体重减轻均有疗效。也可用于其它症状如：对事物丧失兴趣，自杀观念以及情绪波动（早上好，晚上差）。“米氮平-瑞美隆”在用药后一至二周后起效。
药效学特征：瑞美隆的活性成分米氮平是作用于中枢的突触前α2受体拮抗剂，对以增强肾上腺素能的 神经传导。它通过与中枢的5一羟色胺受体(5－HT2，5－HT3)相互作用起调节5一羟色胺的功能。米氮平的二种旋光对映体都具有抗抑郁活性，左旋体阻断α2和5－HT2受体，右旋体阻断5－HT3受体。米氮平的抗组织胺受体（H1）的特性起着镇静作用。该药有较好的耐受性，几乎无抗胆碱能作用，其治疗剂量对心血管系统无影响。
药代学特征：口服“米氮平-瑞美隆”片后其活性成分米氮平很快被吸收（生物利用度约为50％），约二小时后血浆 浓度达到高峰。约85％与血浆蛋白结合。平均半衰期为20－40小时；偶见长达65小时；在年轻人中也偶见较短的半衰期。清除半衰期的大小正适合于将服用方式定为每日一次。 血药浓度在服药三至四天后达到稳志，此后将无体内聚积现象发生。在所推荐的剂量范围内，“米氮平-瑞美隆”的药代动力学形式为线性。米氮平大多被代谢并在服药后几天内通过尿液和粪便排出体外。其主要生化方式为脱甲基及氧化反应在，随后是结合反应。脱甲后的代谢产物与原化合物一样仍具药理活性。
肝肾功能不良可引起米氮平清除率降低。
作用与用途：抑郁症的发作，是抗抑郁药，适用于抑郁症。对症状如快感缺乏，精神运动性抑制，睡眠欠佳（早醒）以及体重减轻均有疗效。
服用方法：“米氮平-瑞美隆”片应口服，如有必要可与水同服，应吞服而不应嚼碎。
成人：“米氮平-瑞美隆”治疗起始剂量应为每日15毫克，逐渐加大剂量至获最佳疗效。有效剂量通常为每日 15－45mg。
肝肾功能不良患者对“米氮平-瑞美隆”的清除率有可能会降低，此类病人使用“米氮平-瑞美隆”时应注意。
瑞美隆的有效成分“米氮平”的半衰期为 20至 40小时，因此该药适于每日服用一次（最好在临睡前服用）。该药也可分次服用（如早晚各一次）。
病人应连续服药，最好在症状完全消失四至六个月后再逐渐停药。当剂量合适时，药物应在二至四周内有显著疗效。若效果不够显著，可将剂量增加直至最大剂量。但若剂量增加二至 四周后仍无作用，应停止使用“米氮平-瑞美隆”。
『原产地英文商品名』MIRTAZAPINE TABLET 15mg/tab 30tabs/box
『原产地英文药品名』MIRTAZAPINE
『中文参考商品译名』
注：以下产品不同的价格和不同规格，凭处方购买，购买时请以电话咨询为准！
·米氮平片剂 45毫克/片 30片/盒
·米氮平片剂 30毫克/片 30片/盒
·米氮平片剂 15毫克/片 30片/盒
『中文参考药品译名』米氮平
Remeron
Generic Name: mirtazapine (mir TAH zah peen)
Brand Names: Remeron, Remeron SolTab
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What is Remeron?
Remeron is a tetracyclic antidepressant. It affects chemicals in the brain that may become unbalanced and cause depression. It is thought to increase the activity of norepinephrine and serotonin which help elevate mood.
Remeron is used to treat major depressive disorder.
Remeron may also be used for purposes other than those listed in this medication guide.
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What is the most important information I should know about Remeron?
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Do not use Remeron if you have used an MAO inhibitor within the past 14 days. Serious, life-threatening side effects can occur if you take Remeron before the MAO inhibitor has cleared from your body.
Before taking Remeron, tell your doctor if you have bipolar disorder, liver or kidney disease, seizures, heart disease, a history of heart attack or stroke, or a history of drug abuse or suicidal thoughts.
It may take up to several weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment. Avoid drinking alcohol. It can increase some of the side effects of Remeron. Remeron can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
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What should I discuss with my healthcare provider before taking Remeron?
You should not take this medication if you are allergic to mirtazapine.
You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
Do not use Remeron if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Remeron before the MAO inhibitor has cleared from your body.
Before taking Remeron, tell your doctor if you are allergic to any drugs, or if you have:
liver or kidney disease;
bipolar disorder (manic depression);
seizures or epilepsy;
heart disease, including angina (chest pain);
a history of heart attack or stroke; or
a history of drug abuse or suicidal thoughts.
If you have any of these conditions, you may not be able to use Remeron, or you may need a dosage adjustment or special tests during treatment.
Remeron is in the FDA pregnancy category C. This means that it is not known whether Remeron will harm an unborn baby. Do not take Remeron without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Remeron passes into breast milk. Do not take Remeron without first talking to your doctor if you are breast-feeding a baby.
Older adults may be more sensitive to the side effects of this medication.
The orally disintegrating tablet may contain phenylalanine. Talk to your doctor before using this form of mirtazapine if you have phenylketonuria (PKU).
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How should I take Remeron?
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.
Take the regular tablet form of mirtazapine with water.
To take mirtazapine orally disintegrating tablets (Remeron SolTab):
Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may break the tablet.
Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.
Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
Swallow several times as the tablet dissolves. No water is needed.
Remeron is usually taken once a day at bedtime. Follow your doctor's instructions.
It may take up to several weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment. Store Remeron at room temperature, away from moisture and heat.
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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include confusion, memory problems, drowsiness, and fast heart rate.
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What should I avoid while taking Remeron?
Avoid drinking alcohol. It can increase some of the side effects of mirtazapine. Remeron can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
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Remeron side effects
Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:
fever, chills, body aches, flu symptoms;
white patches or sores inside your mouth or on your lips; or
feeling like you might pass out.
Less serious side effects include:
drowsiness, dizziness, weakness;
nausea, stomach pain;
constipation;
increased appetite, weight gain;
dry mouth; or
thirst.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
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What other drugs will affect Remeron?
Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Remeron. Tell your doctor if you need to use any of these other medicines while you are taking Remeron.
There may be other drugs that can interact with Remeron. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
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Where can I get more information?
Your pharmacist can provide more information about Remeron.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.