Mirapro 15

Indications

Mirapro Tablets are prescribed for managing major depressive disorder (MDD).

Pharmacology

Pharmacodynamics: The precise mechanism of action of Mirtazapine, like other drugs used in treating major depressive disorder, remains unclear. Preclinical studies suggest that Mirtazapine enhances central noradrenergic and serotonergic activity by acting as an antagonist at central presynaptic α2-adrenergic inhibitory autoreceptors and heteroreceptors. Additionally, it acts as a potent antagonist of 5-HT2 and 5-HT3 receptors, with moderate affinities for histamine (H1), peripheral α1-adrenergic, and muscarinic receptors.

Pharmacokinetics: Mirtazapine is rapidly absorbed after oral administration, reaching peak plasma levels within approximately 2 hours. It has a mean elimination half-life of 20-40 hours, supporting once-daily dosing. Metabolism primarily occurs through demethylation and oxidation followed by conjugation, with elimination via urine and feces.

Dosage & Administration

For adults, the initial dose of Mirtazapine tablets is typically 15 mg/day, preferably taken in the evening or before bedtime. The effective dose range is generally 15 to 45 mg/day, with adjustments made at intervals of 1 to 2 weeks. Mirtazapine is not recommended for use in children.

Missed Dose

If a dose is missed, it should be taken as soon as remembered unless it is close to the next scheduled dose. Avoid doubling up on doses.

Interactions

Mirapro may have significant interactions with Monoamine Oxidase Inhibitors (MAOIs), other serotonergic drugs, carbamazepine, phenytoin, cimetidine, alcohol, and diazepam. Patients should be cautious when combining these medications.

Contraindications

Mirapro is contraindicated in individuals with known hypersensitivity to Mirtazapine or any of its components, as well as those taking MAOIs or within 14 days of discontinuing MAOI therapy.

Side Effects

Common side effects of Mirapro include dizziness, drowsiness, dry mouth, increased appetite, and weight gain.

Pregnancy & Lactation

Mirapro falls under Pregnancy Category C. Patients should inform their healthcare provider if they are pregnant or planning to become pregnant while on Mirtazapine therapy. Breastfeeding mothers should also consult their physician.

Precautions & Warnings

Patients and caregivers should be vigilant for changes in behavior, mood swings, or suicidal ideation, especially at the onset of treatment or dosage adjustments. Additionally, caution is advised regarding motor skills due to its sedative effects. Clinically significant ALT (SGPT) elevations may occur.

Therapeutic Class

Mirapro belongs to the therapeutic class of atypical antidepressant drugs.

Storage Conditions

Store Mirapro away from light and moisture, below 30°C, and out of reach of children.