Mirtel 30s 30 mg film-coated tablets
- $85.80
Pharmacological action
Antidepressant. The antagonist presynaptic α2-адренорецепторов in central nervous system. Strengthens the central adrenergic and serotonergic transfer of nervous impulses. Blocks serotoninovy 5-HT2- and 5-HT3-retseptory, in this regard strengthening of serotonergic transfer is implemented only through serotoninovy 5-HT1-receptors. Both spatial enantiomer participate in manifestation of antidepressive activity: S (+)-enantiomer blocks α2-адренорецепторы both serotoninovy 5-HT2-receptors and R (+)-enantiomer blocks serotoninovy 5-HT3-receptors. Moderately blocks histamine H1 receptors, has sedative effect.
Drug eliminates depression symptoms (change of mood, lack of mood, uneasiness, suicide thoughts). Is especially effective at an angedoniya, disturbances of psychomotor functions, sleep disorders (early awakening), loss of weight.
Drug is usually well transferred. In therapeutic doses has practically no anticholinergic effect and impact on a cardiovascular system.
The antidepressive effect is shown in 1-2 weeks of treatment.
The pharmacokinetics
Absorption
After intake mirtazapin is quickly and intensively absorbed from a GIT, at this Cmax is reached approximately in 2 h. Bioavailability - about 50%. Meal does not influence drug pharmacokinetics.
Distribution
Linking with proteins of plasma makes about 85%. Css is established in 3-5 days of constant reception. Cumulation is not noted.
In the recommended range of doses the pharmacokinetic parameters of a mirtazapin are characterized by a linear dozozavisimost.
Metabolism
Mirtazapin is actively metabolized. The main ways of his metabolism in an organism are demethylation and oxidation with the subsequent conjugation. The researches in vitro showed that isoenzymes of CYP2D6 and CYP1A2 participate in formation of a 8-hydroxy-metabolite of a mirtazapin, CYP3A4 defines formation of N-desmetil and N-oxide of metabolites.
N-desmetil a metabolite is pharmacological active and has the pharmacological parameters similar to active agent.
Removal
Is removed with urine and a stake within several days.
Average T1/2 makes from 20 to 40 h (sometimes - up to 65 h).
The pharmacokinetics in special clinical cases
of T1/2 at men of young age is shorter, than at elderly patients.
The clearance of a mirtazapin decreases in a renal or liver failure.
Indications
— treatment of depressions.
The dosing mode
For adults the initial daily dose makes 15-30 mg, an effective daily dose - 15-45 mg. The most part of a daily dose should be accepted in the evening.
To patients of advanced age drug is appointed in the same doses, as to younger patients. For achievement of satisfactory clinical effect and safety the increase in a dose of this category of patients should be carried out under medical control.
At patients with a renal and/or liver failure when prescribing drug it is necessary to consider decrease in discharge of a mirtazapin at this category of patients.
Drug is appointed 1 time / (to night). The general daily dose can be divided into two separate doses (in the morning and in the evening, and the most part of a daily dose is accepted in the evening).
A course of treatment - 4-6 months. Drug is cancelled gradually.
At reception of the recommended dose the therapeutic effect of drug is noted in 2-4 weeks. If the sufficient effect is not observed, the dose can be increased to maximum. In the absence of desirable effect within the next 2-4 weeks the treatment should be stopped.
A pill is taken entirely, without chewing and washing down with a small amount of water, time of day is desirable in one and too. Tablets have dividing to risk, and they can be divided.
Side effect
from central nervous system and peripheral nervous system: drowsiness, disturbance of ability to concentration of attention (are more often noted in the first weeks of treatment, at the same time the dose decline usually does not lead to reduction of sedative action, but can reduce antidepressive effect), vertigo, a headache, a mania, spasms, a tremor, muscular twitchings, paresthesia, feeling of fatigue, nightmares / bright dreams, restless legs syndrome.
From the system of a hemopoiesis: intense oppression of a marrowy hemopoiesis (granulocytopenia, agranulocytosis, aplastic anemia and thrombocytopenia), eosinophilia.
From digestive system: increase in activity of transaminases in blood plasma.
From an urinary system: edematous syndrome.
From a cardiovascular system: orthostatic collapse, decrease in the ABP.
Other: increase in appetite and increase in body weight, arthralgia, myalgia, rash.
Contraindications
— hypersensitivity to a mirtazapin or other components of drug.
Use at pregnancy and feeding by a breast
Safety of use of the drug Mirtel at pregnancy is not established. Prescribing of drug is possible only in cases when the expected advantage for mother exceeds potential risk for a fruit (the patient has to be under careful medical control).
In pilot studies on animals it is established what mirtazapin is allocated with breast milk in insignificant quantities. Use of drug in the period of a lactation (breastfeeding) is not recommended (since there are no data on discharge of a mirtazapin with breast milk at the person).
In pilot studies the teratogenic effect of drug is not revealed.
Use in abnormal liver functions
With care it is necessary to appoint drug in a liver failure.
Use in renal failures
With care it is necessary to appoint drug in a renal failure.
Release according to the prescription.
Antidepressant. The antagonist presynaptic α2-адренорецепторов in central nervous system. Strengthens the central adrenergic and serotonergic transfer of nervous impulses. Blocks serotoninovy 5-HT2- and 5-HT3-retseptory, in this regard strengthening of serotonergic transfer is implemented only through serotoninovy 5-HT1-receptors. Both spatial enantiomer participate in manifestation of antidepressive activity: S (+)-enantiomer blocks α2-адренорецепторы both serotoninovy 5-HT2-receptors and R (+)-enantiomer blocks serotoninovy 5-HT3-receptors. Moderately blocks histamine H1 receptors, has sedative effect.
Drug eliminates depression symptoms (change of mood, lack of mood, uneasiness, suicide thoughts). Is especially effective at an angedoniya, disturbances of psychomotor functions, sleep disorders (early awakening), loss of weight.
Drug is usually well transferred. In therapeutic doses has practically no anticholinergic effect and impact on a cardiovascular system.
The antidepressive effect is shown in 1-2 weeks of treatment.
The pharmacokinetics
Absorption
After intake mirtazapin is quickly and intensively absorbed from a GIT, at this Cmax is reached approximately in 2 h. Bioavailability - about 50%. Meal does not influence drug pharmacokinetics.
Distribution
Linking with proteins of plasma makes about 85%. Css is established in 3-5 days of constant reception. Cumulation is not noted.
In the recommended range of doses the pharmacokinetic parameters of a mirtazapin are characterized by a linear dozozavisimost.
Metabolism
Mirtazapin is actively metabolized. The main ways of his metabolism in an organism are demethylation and oxidation with the subsequent conjugation. The researches in vitro showed that isoenzymes of CYP2D6 and CYP1A2 participate in formation of a 8-hydroxy-metabolite of a mirtazapin, CYP3A4 defines formation of N-desmetil and N-oxide of metabolites.
N-desmetil a metabolite is pharmacological active and has the pharmacological parameters similar to active agent.
Removal
Is removed with urine and a stake within several days.
Average T1/2 makes from 20 to 40 h (sometimes - up to 65 h).
The pharmacokinetics in special clinical cases
of T1/2 at men of young age is shorter, than at elderly patients.
The clearance of a mirtazapin decreases in a renal or liver failure.
Indications
— treatment of depressions.
The dosing mode
For adults the initial daily dose makes 15-30 mg, an effective daily dose - 15-45 mg. The most part of a daily dose should be accepted in the evening.
To patients of advanced age drug is appointed in the same doses, as to younger patients. For achievement of satisfactory clinical effect and safety the increase in a dose of this category of patients should be carried out under medical control.
At patients with a renal and/or liver failure when prescribing drug it is necessary to consider decrease in discharge of a mirtazapin at this category of patients.
Drug is appointed 1 time / (to night). The general daily dose can be divided into two separate doses (in the morning and in the evening, and the most part of a daily dose is accepted in the evening).
A course of treatment - 4-6 months. Drug is cancelled gradually.
At reception of the recommended dose the therapeutic effect of drug is noted in 2-4 weeks. If the sufficient effect is not observed, the dose can be increased to maximum. In the absence of desirable effect within the next 2-4 weeks the treatment should be stopped.
A pill is taken entirely, without chewing and washing down with a small amount of water, time of day is desirable in one and too. Tablets have dividing to risk, and they can be divided.
Side effect
from central nervous system and peripheral nervous system: drowsiness, disturbance of ability to concentration of attention (are more often noted in the first weeks of treatment, at the same time the dose decline usually does not lead to reduction of sedative action, but can reduce antidepressive effect), vertigo, a headache, a mania, spasms, a tremor, muscular twitchings, paresthesia, feeling of fatigue, nightmares / bright dreams, restless legs syndrome.
From the system of a hemopoiesis: intense oppression of a marrowy hemopoiesis (granulocytopenia, agranulocytosis, aplastic anemia and thrombocytopenia), eosinophilia.
From digestive system: increase in activity of transaminases in blood plasma.
From an urinary system: edematous syndrome.
From a cardiovascular system: orthostatic collapse, decrease in the ABP.
Other: increase in appetite and increase in body weight, arthralgia, myalgia, rash.
Contraindications
— hypersensitivity to a mirtazapin or other components of drug.
Use at pregnancy and feeding by a breast
Safety of use of the drug Mirtel at pregnancy is not established. Prescribing of drug is possible only in cases when the expected advantage for mother exceeds potential risk for a fruit (the patient has to be under careful medical control).
In pilot studies on animals it is established what mirtazapin is allocated with breast milk in insignificant quantities. Use of drug in the period of a lactation (breastfeeding) is not recommended (since there are no data on discharge of a mirtazapin with breast milk at the person).
In pilot studies the teratogenic effect of drug is not revealed.
Use in abnormal liver functions
With care it is necessary to appoint drug in a liver failure.
Use in renal failures
With care it is necessary to appoint drug in a renal failure.
Release according to the prescription.
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